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CMS Issues 2023 SNF Final Payment Rule

Last week, the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 update. MHCA would like to thank all of the members who wrote letters and submitted comments on the proposed rule. Your advocacy efforts had tremendous impact on the outcome! 
 
Highlights of the final rule include:
 
  • In April 2022, CMS proposed a negative 0.7 net Market Basket. The final rule provides a net market basket increase for SNFs of 2.7 percent beginning October 1, 2022. This was the result of the hard work of AHCA staff and thousands of members who submitted comments to CMS.
 
  • The 2.7 percent market basket update, after rounding, reflects:
 
  • An unadjusted market basket increase of 3.9 percent increased by 1.5 percent associated with a forecast error adjustment;
  • A reduction of 0.3 percentage points in accordance with the multifactor productivity adjustment required by Section 3401(b) of the Affordable Care Act (ACA); and
  • A 2.3 percent negative adjustment accounting for year one of a two-year PDPM parity adjustment phase-in. 
 
  • CMS net market basket update would increase Medicare SNF payments by approximately $904 million in FY 2023. 
 
  • CMS will apply the 4.6 percent parity adjustment amount as proposed but will phase-in the adjustment over two years (2.3 percent applied in FY 2023, and 2.3 percent in FY 2024). CMS applied the parity adjustment equally across all components.
 
The American Health Care Association (AHCA) has provided a summary of the final rule. If you have any questions, please contact the relevant subject matter expert listed in the summary.
 
Access the summary here.
 
Staff contact: awesthoff@mehca.org