CMS Issues 2019 Proposed Rule for SNFs

Carl J. Pucci in Finance & Reimbursement

CMS issued its Fiscal Year 2019 Proposed Rule for SNFs late Friday afternoon. The proposed rule includes a market basket increase of 2.4% for nursing home providers (approximately $850M nationwide), effective 10/1/18. 

Based on stakeholder feedback, CMS proposed Resident Classification System-1 (RCS-1) has been revised and renamed the “Patient-Drive Payment Model” (PDPM) slated to become effective 10/1/19. Although PDPM retains the elimination of the RUGS MDS and therapy assessment requirements of the RCS-1, it does condense the number of case mix groups, and also tapers payments on different days for PT and OT.

In addition, a webinar is slated for 4:30 pm today to review the rule in its entirety. (Note: the webinar will be archived for later viewing). Specific details are provided in the AHCA summary attached, including webinar registration instructions. 

NYSHFA will monitor development of the proposed rule through its anticipated adoption over the summer and keep members updated throughout this process. 


Carl J. Pucci
Chief Financial Officer
|518-462-4800 x36