On March 28^th, 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 Money 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.

To learn more about the proposed rule:

• Our national affiliate, AHCA/NCAL hosted a webinar on Friday, April 5^th at 9:00 am Central. The recording will be made available here;
• AHCA/NCAL has also provided a more detailed summary of the proposal; View Summary Here
• See also: CMS fact sheet and view the proposed rule in the Federal Register.

Questions about the proposal? Please contact Kate Dickson, VP for Reimbursement Policy, kate@whcawical.org.