CMS final rule for fiscal year (FY) 2015, released July 31, delivers good news to skilled nursing facilities (SNF). SNF reimbursements will increase by $750 million next year under the final payment rule.
On July 31, HHS issued a rule finalizing October 1, 2015, as the new compliance date for healthcare providers, health plans, and clearinghouses to transition to ICD-10. This deadline allows providers, insurance companies, and others in the healthcare industry time to ramp up their operations to ensure their systems and business processes are ready to go on the compliance date.
On July 24, the House Committee on Ways and Means Subcommittee on Health held a hearing to examine the status of the Medicare Advantage (MA) program and the impact of the Affordable Care Act (ACA) on the program.
An explanation is in order. Originally, when billing for all Medicare Advantage organizations (MAO), PACE organizations, cost plans, and certain demonstration projects, providers were told by CMS that they must provide health insurance prospective payment system (HIPPS) codes for skilled nursing facility (SNF) claims submitted effective July 1, 2014. This left SNF providers concerned that they would then be required to follow the traditional Medicare PPS schedule in order to accurately provide HIPPS codes for billing. On May 23, 2014, CMS released a memo regarding submission of HIPPS codes to the encounter data system to all MAO providers clarifying the requirements.