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SNF Prospective Payment System Final Rule Now Available
The Centers for Medicare & Medicaid Services has released the Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Final Rule.
The final rule includes updates to Medicare payment policies and rates for skilled nursing facilities, as well as finalized changes to the SNF Quality Reporting Program and SNF Value-Based Purchasing Program.
For FY 2027, CMS finalized a 2.4% update to SNF PPS rates. CMS notes that this update is based on a 3.3% final SNF market basket update, reduced by a 0.9% productivity adjustment. While CMS estimates an aggregate increase in SNF payments, individual facility impact may vary based on factors such as market basket changes, wage index adjustments, case mix, and other facility-specific considerations.
One of the most significant operational changes finalized in the rule is a new requirement for SNFs to submit Minimum Data Set data for all SNF residents receiving covered skilled care, regardless of payer. This means residents receiving skilled care under Medicare Advantage and other payer sources will be included in SNF Quality Reporting Program data. CMS states that this change is intended to support more accurate SNF quality of care information and align the SNF QRP with other post-acute care settings and CMS programs that collect data regardless of payer.
CMS also finalized several SNF QRP updates, including the removal of two COVID-19 vaccination measures beginning with the FY 2028 SNF QRP and a revised data submission timeframe beginning with the FY 2029 SNF QRP. The data submission timeframe will be shortened from 4.5 months to approximately 45 days, which CMS states will reduce the lag between data submission and public reporting.
In addition, CMS finalized updates to the SNF Value-Based Purchasing Program and addressed a Request for Information related to potential future updates to the Patient Driven Payment Model payment system and case-mix upcoding.
SNF operators should review the final rule carefully, with particular attention to the all-payer MDS submission requirement and the upcoming SNF QRP timeline changes.
The Hansen Hunter team is here to help if you have questions.