CMS Issues FY 2025 SNF Proposed Payment Rule

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2025.

Highlights include:

  • The proposed rule would increase SNF PPS rates by 4.1%, or approximately $1.3 billion, beginning October 1, 2024. This is based on the proposed SNF market basket increase of 2.8%, plus a 1.7% market basket forecast error adjustment, and a negative 0.4% productivity adjustment.
  • The above impact figures do not incorporate the SNF Value-Based Purchasing (VBP) reductions for certain SNFs subject to the net reduction in payments under the SNF VBP; those adjustments are estimated to total $196.5 million in FY 2025. CMS is proposing several operational and administrative proposals for the SNF VBP program.
  • The proposed rule includes updated guidelines surrounding enforcement authority, related to Civil Monetary Penalties (CMP). Under the proposed rule, State Survey Agencies, along with CMS would have the authority to issue Per Diem and Per Instance CMPs on the same survey, and the authority to issue multiple Per Instance CMPs for the same type of noncompliance.
  • CMS also proposes updates to the SNF Quality Reporting Program (QRP) and to update the SNF PPS wage index.

Learn more in the CMS fact sheet and view the proposed rule in the Federal Register.

AHCA is currently reviewing the proposed rule in greater detail and will share a more detailed summary in the coming days. AHCA will also host a member webinar on Friday, April 5, 2024. More information, including the registration link, will be provided soon. The webinar will be recorded for those unable to participate in person.

Posted in CMS, Skilled Nursing