Submit Comments by June 10: Fiscal Year 2023 Proposed Rule
CMS issued the Fiscal Year (FY) 2023 Skilled Nursing Facility Prospective Payment System proposed rule to update skilled nursing facility (SNF) payment policies and rates. See a summary of key provisions. Proposals include:
- Requests for input to help us establish minimum staffing requirements and the role health equity has on better health outcomes in nursing homes
- Patient Driven Payment Model (PDPM) parity adjustment recalibration (use the PDPM calculator (ZIP) to learn more) and changes in ICD-10 code mappings
- Permanent 5% cap on annual wage index decreases
- SNF Quality Reporting Program (QRP): compliance date revisions for certain QRP requirements and new influenza vaccination coverage for health care personnel measure
- SNF Value Based Purchasing (VBP): suppress the SNF 30-Day All Cause Readmission Measure for the FY 2023 program year and add 3 new measures for FY 2026 & 2027 SNF VBP program expansion years
We encourage you to review the rule, and submit formal comments by June 10, 2022.
ABN Form Renewal
The Office of Management and Budget approved the Advance Beneficiary Notice of Noncoverage (ABN) (Form CMS-R-131 (ZIP)) and instructions (PDF) for renewal. You must use the renewed form with the expiration date of June 30, 2023, beginning August 31. There are no other changes to the form. Visit the ABN webpage for more information.
- Jimmo v. Sebelius Settlement Agreement – Program Manual Clarifications (Fact Sheet)
As explained in the previously-issued Jimmo v. Sebelius Settlement Agreement Fact Sheet (see Downloads section on the SNF PPS web page), the Centers for Medicare & Medicaid Services (CMS) is issuing revised portions of the relevant program manuals used by Medicare contractors. For additional information, please see the Jimmo v. Sebelius Settlement Agreement – Program Manual Clarifications (Fact Sheet) - Updated 2/3/2014 (PDF) . The Manual Updates to Clarify Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), Home Health (HH), and Outpatient (OPT) Coverage Pursuant to Jimmo vs. Sebelius can be found in CR 8458 (PDF) and in associated MLN Matters Article, MM8458 (PDF)