Medicare Proposes SNF Payment Overhaul

An overhaul to Medicare’s payment system for beneficiaries in skilled nursing facilities—which would use patients’ clinical characteristics, such as diagnoses and other factors—is scheduled to take place Oct. 1, 2019. The proposed rule from the Centers for Medicare and Medicaid Services (CMS) would eliminate Medicare Part A (inpatient) payment for skilled nursing facilities (SNFs) based on the amount of therapy the beneficiary receives. Under the proposal, a SNF would receive payment for physical therapy, occupational therapy, and/or speech-language pathology services based on the patient’s diagnosis and other characteristics. Previously, SNFs received a payment for general therapy based on the number of therapy minutes provided. CMS research indicates that in addition to the patient’s primary diagnosis (usually acute neurologic conditions), the need for speech-language services related to a swallowing disorder, a mechanically altered diet, a comorbidity related to speech-language disorders, and/or cognitive impairment warrants additional payments. Various combinations of these characteristics produce 12 speech-language pathology case-mix groups. For example, if a patient has an acute neurologic condition, a comorbidity related to a speech-language disorder, a cognitive impairment, a swallowing disorder and a mechanically altered diet, reimbursement for that patient would be higher than for a patient with “only” an acute neurologic condition and sw...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Slider Speech-Language Pathology medicare reimbursement skilled nursing facility Source Type: blogs