CMS TO Delay $1B Cut in Payments To Nursing Homes

CMS announced on April 23 that it will delay implementing a payment system change that was expected to result in a $1 billion cut in payments to nursing homes this year, the Wall Street Journal reports (Wall Street Journal, 4/24). The decision means the current classification system, under which nursing homes are paid daily rates according to "the needs of Medicare beneficiaries," will remain in effect next year. Congress had encouraged CMS to make "case-mix refinements" in order to reimburse nursing homes who take care of "medically complex patients" more fairly and accurately. "After careful review of the available data and research, CMS determined that while the research shows promise for developing improvements to the skilled nursing facility prospective payment system, the research is not sufficiently advanced at the present time to implement refinements this year," HHS said in a press release (HHS release, 4/23). The nursing home industry had lobbied to stop the payment change, saying it would produce "dire consequences." John Schaeffler, vice president of legislative affairs for the American Health Care Association, which represents 12,000 skilled nursing and assisted living facilities, said the decision was "very positive." The decision does not affect two temporary reimbursement increases to nursing homes totaling $1.4 billion that are scheduled to expire on Oct. 1 and require congressional action to be continued (Wall Street Journal, 4/24).