CMS Releases FY 2024 Improper Payment Data: Key Insights for SNF Providers

• By: Maureen Carland
• On: 12/06/2024 09:15:30
• In: Quality/Regulatory

The U.S. Department of Health and Human Services (HHS) recently released the Fiscal Year 2024 Agency Financial Report, detailing Medicare Fee-for-Service (FFS) paid claims error rates for Part A and Part B services during October 2023 through September 2024.

Key Highlights for Skilled Nursing Facilities (SNFs)
In FY 2024, Medicare accurately paid 92.34% of total Part A and Part B outlays, amounting to $382.02 billion. However, the improper payment rate across all providers was 7.66%, or $31.70 billion. 
For SNF claims, the improper payment rate saw a notable increase from 13.76% in FY 2023 to 17.2% in FY 2024. 
CMS also released the 2024 Medicare FFS Supplemental Improper Payment Data report, which identifies root causes of SNF Medicare Part A claim errors. Most errors stemmed from documentation and signature issues rather than medical necessity concerns, suggesting these issues are correctable.

Action Steps for SNF Providers to Reduce Payment Errors and Audit Risks
The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) anticipates heightened Medicare contractor claim reviews until SNF error rates decline. To minimize risks, SNF providers should: 
  Enhance documentation quality and accuracy. 
  Improve MDS and claim coding practices. 
  Conduct thorough pre-MDS submission and pre-claim submission checks, including triple-check processes. 
  Proactive measures in these areas can help providers mitigate errors and reduce the likelihood of audits.
 
Staff contact: mcarland@mehca.org