News, Skilled Nursing Facility

CMS welcomes feedback on proposed case-mix rule, extends comment deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the comment deadline for the advance notice of proposed revisions to case-mix methodology rule from June 26, 2017 to August 25, 2017. The advance notice of proposed rulemaking, titled “Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology,” was published in the Federal Register on May 4 and solicits comments on the possibility of replacing the SNF PPS’ existing case-mix classification model—the RUG-IV—with a new payment model that determines care based on resident characteristics (as opposed to minutes), the Resident Classification System (RCS-1).

The advance notice also proposes additional changes such as a simplified MDS structure, a “front loading” or “block pricing” payment approach, and a potential limit placed on therapy delivery.

In their memo to extend the comments deadline, CMS notes that they cannot receive comments via facsimile. Providers submitting comments (electronically, by mail, by express/overnight mail, or by hand/courier) should refer to file code CMS-1686-ANPRM.