The Centers for Medicare & Medicaid Services’ proposed patient-driven payment model for skilled nursing facilities would increase overall payment accuracy, especially for the medically complex patients treated by hospital-based providers, but needs refinement, AHA told the agency in comments submitted today. “The AHA appreciates the extensive work CMS has done to develop an alternative to the current SNF case-mix system,” AHA wrote. “As noted in the rule, the current system has been widely criticized by policymakers for overly concentrating payments on cases with high-therapy utilization…However, our evaluation of the PDPM found that the model still has several flaws, which must be addressed before the PDPM proposal can be finalized.” In its FY 2019 proposed rule for the SNF prospective payment system, CMS proposes the model as an alternative to the current SNF case-mix system beginning in FY 2020.

Related News Articles

Headline
Senate Health, Education, Labor, and Pensions Committee Chairman Bill Cassidy, M.D., R-La., today released a report detailing findings from an investigation…
Headline
The AHA April 18 filed friend-of-the-court briefs in three cases in support of Louisiana's 340B contract pharmacy law that prohibits drug companies from…
Headline
A Minnesota state court April 15 dismissed a lawsuit filed by PhRMA challenging the state’s law protecting 340B pricing for contract pharmacy arrangements. The…
Headline
The White House April 15 released an executive order directing federal agencies to undertake a broad range of tasks aimed at reducing the costs of prescription…
Headline
The AHA March 27 made a series of recommendations to the Physician‐Focused Payment Model Technical Advisory Committee to address barriers to participating in…
Headline
The Department of Health and Human Services said its decision to prevent drug companies from implementing a 340B rebate model “was within its statutory…