Medicare Compliance & Reimbursement

What's brewing in the financial forecast for 2005.

Good news for hospitals and skilled nursing facilities.
 
The Centers for Medicare & Medicaid Services has updated prospective payment system rates for 2005, and things are looking up.
 
For discharges starting Oct. 1, 2004, IRFs are slated to receive a 3.1-percent annual increase while SNFs can look forward to a 2.8-percent or $440 million pay hike.
 
Overall IRF payments are projected at $5.7 billion, according to CMS. That's up 5.6 percent from earlier projections of $5.4 billion. However, CMS continues to back controversial regulations published earlier this year which stipulate that in order to continue to receive payment under the IRF PPS, 75 percent of a facility's patients must have one of 13 diagnosed conditions. SNFs will be allowed to retain resource utilization groups, which make room for $1 billion in temporary add-on payments. CMS says it will also be taking further steps to toughen up enforcement and oversight activities in nursing homes, and will target how quality of care information gets publicly reported.
 
To read the notices in the July 30 Federal Register, go to http://www.access.gpo.gov/su_docs/fedreg/a040730c.html.