The government sequestration that took effect on March 1, mandated by the Budget Control Act of 2011, produced budget cuts that totaled $85.4 billion. Although Medicaid was exempt from these cuts, beginning on April 1, Medicare saw a 2% cut across the board.
In May, CMS released a proposed rule concerning Medicare payment and policy changes for SNFs for fiscal year 2014. The proposed rule includes a 1.4% increase (or $500 million) to the PPS system, which accounts for a 2.3% market basket increase, minus 0.5% forecast error correction and a 0.4% multifactor productivity adjustment outlined in the Affordable Care Act.
States looking to boost their budget may have found one way to create a little wiggle room thanks to the OIG's release of its "Updated OIG Guidelines for Evaluating State False Claims Acts." But SNFs aren't likely to share their excitement.
Healthcare providers should be at least slightly relieved about the latest update from CMS regarding additional documentation requests (ADR). The recent announcement indicated that new limits will decrease the volume of documentation requests that Recovery Auditors are allowed to make.
On March 15, the Medicare Payment Advisory Commission (MedPAC) issued its annual report to Congress, which evaluates deficiencies in the Medicare payment system and makes recommendations to Congress regarding necessary improvements.
The Common Working File (CWF), one of the primary tools utilized by CMS to maintain national Medicare records, determine eligibility of individuals, and track usage of Medicare benefits, is on its last leg. In a September 2012 issue of MLN Matters, CMS announced that it would be replacing the CWF with the HIPAA Eligibility Transaction System (HETS) to track beneficiary information.
A new report released in November by the OIG reveals startling statistics regarding reimbursement claims submitted to CMS by SNFs in 2009, adding to the already pervasive concern about SNFs improperly billing for therapy in order to obtain additional Medicare reimbursement.