Eli's Rehab Report

Published on Fri Jun 27, 2014 PDF

SNF PPS changes small for now, but big plans on the horizon.

The Centers for Medicare & Medicaid Services (CMS) has rolled out its proposal for 2015 SNF payments (http://tinyurl.com/mrunem8). 

Along with a 2 percent payment update, CMS has suggested tweaking change of therapy (COT) policies. The change would allow patients who were previously under a therapy resource utilization group (RUG) to be re-classified into a therapy RUG via a COT other Medicare required assessment (OMRA).

Good news: This change would be positive, according to Mark Kander, MPH, director of regulatory analysis for the American Speech-Language Hearing Association. “The COT OMRA would allow a patient to get switched back into rehab status more quickly.” Currently the wait can be up to a week. 

This situation, however, is not a regular occurrence. “Therapy is very conscious of its time, and usually when a COT is done, it is because of patients that are more medically challenged and miss therapy because of doctor visits, not feeling up to therapy, etc.,” says Pauline M. Franko, PT, CEEAA, owner of Encompass Consulting & Education, LLC in Tamarac, FL. “I believe that CMS is back to tweaking the regulations.” 

Quiet changes, however, for PPS for 2015 could be the calm before the storm. A report released alongside the proposed rule (http://tinyurl.com/jw7pg2d) speaks in detail of new payment alternatives. Watch for more on these payment models in the next issue of Eli’s Rehab Report.