Medicare Part A SNF PPS Pricer Update – FY2017
From: CMS MLN Matters – MM9712; 7/1/16
Background
Annual updates to the PPS rates are required by Section 1888(e) of the Social Security Act as amended by the Medicare, Medicaid, and the State Children’s Health Insurance Plan (SCHIP) Balanced Budget Refinement Act of 1999 (the BBRA), the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (the BIPA), and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the MMA), relating to Medicare payments and consolidated billing for SNFs. Each July, the Centers for Medicare & Medicaid Services (CMS) publishes the SNF payment rates for the upcoming fiscal year (that is, October 1, 2016, through September 30, 2017) in the Federal Register.
The update methodology is identical to that used in the previous year, which includes a forecast error adjustment whenever the difference between the forecasted and actual change in the SNF market basket exceeds 0.5 percentage point. The statute mandates an update to the Federal rates using the latest SNF full market basket adjusted for productivity. The payment rates will be effective October 1, 2016.
