Fixes to SNF Medicare payment system and resolution to therapy cap funding are immediate needs for seniors and caregivers

FHCA's national affiliate, American Health Care Association (AHCA), and the Alliance for Quality Nursing Home Care today urged the U.S. Congress to fully implement the new Medicare payment system for skilled nursing facilities (SNFs) in addition to extending the Medicare Part B therapy exceptions process.


“The groundwork for fully implementing the new RUG IV payment system has been laid,” said Bruce Yarwood, President & CEO of AHCA and Alan G. Rosenbloom, President of the Alliance. “There is no cost to this necessary change. We are almost there. Congress is too close to fail on this. So we urge congressional leaders to bring these two measures across the finish line in these final days so we can continue doing what we do best – delivering exceptional care to residents and patients.”

Failure to act, they added, would bring about “an operational nightmare for facilities,” and require the Centers for Medicare and Medicaid Services (CMS) to modify the payment system yet again, making payment policies even more uncertain. Acting to ensure patients and caregivers were protected in the face of sweeping modifications during unsettling economic times, in 2009 SNF providers sought a one-year delay in implementing two of three regulatory changes to the SNF Medicare Payment system. However, only one of the changes was delayed. The House has passed this technical fix, and there is unanimity among the SNF community, CMS and the Medicare Payment Advisory Committee (MedPAC) to address the matter. The Senate’s failure to act is the last remaining impediment to a resolution.

In addition, Yarwood and Rosenbloom said Congress must act by December 31, 2010 in regard to Medicare Part B therapy exceptions process, or Medicare patients will be limited in the amount of Part B physical, occupational, and speech-language therapies they are allowed to receive that helps restore them to their highest level of functioning.

"For skilled nursing facility patients, the December 31 deadline is critical, since the health care reform law only extends the exceptions process until that time,” continued the AHCA and Alliance leaders. “Congress must not allow its unfinished business to impede the ability of Medicare beneficiaries to access the professional therapy services they require to maximize their quality of life and functional independence.”