MLN Notice on FY 2018 and After Payments SNFs That Do Not Submit Required Quality Data

Holly Harmon

CMS released a MLN Matters Article last week regarding FY 2018 and after payments for SNFs that do not submit required quality data. Beginning with FY 2018, and each subsequent year, if a SNF does not submit required quality data, their payment rates for the year are reduced by two percentage points for that fiscal year. 

Application of the two percentage reduction may result in an update that is less than 0.0 for a fiscal year and in payment rates for a fiscal year being less than such payment rates for the preceding fiscal year. In addition, reporting-based reductions to the market basket increase factor will not be cumulative; they will only apply for the FY involved.

The initial SNF Quality Reporting Program (QRP) requirement period was quarter 4, 2016, which affects FY 2018 annual payment update. The next SNF QRP requirement period is quarter 1, 2017, through quarter 4, 2017, and will affect FY 2019 annual payment updates.  

Further details on the SNF QRP requirements can be found on the CMS SNF QRP website or by contacting CMS here.