National Government Services, Inc. Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter

Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update for FY 2008  

Provider Types Affected
Skilled nursing facilities (SNF) billing Medicare fiscal intermediaries (FI) for services paid under the SNF PPS  

Background
Annual updates to the PPS rates are required by §1888(e) of the Social Security Act, as amended by the Medicare, Medicaid, and 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.

The Centers for Medicare & Medicaid Services (CMS) published the SNF payment rates for FY 2007 (October 1, 2006 through September 30, 2007) in the Federal Register on July 31, 2006 (71 FR 43159.) This article reminds SNFs that the annual update of the rates will be announced soon.

CR5688 Key Points

• The Fiscal Year (FY) 2008 SNF payment rates will be effective October 1, 2007, through September 30, 2008.
• The update methodology is identical to that used in the previous year and will include the MMA reimbursement for beneficiaries with AIDS.
• The statute mandates an update to the Federal rates using the latest SNF full market basket.

Additional Information
Market Basket Definitions and General Information can be found at http://www.cms.hhs.gov/MedicareProgramRatesStats/downloads/info.pdf on the CMS Web site.

The official instruction, CR5688, issued to your Medicare FI or A/B MAC regarding this change can be found at http://www.cms.hhs.gov/Transmittals/downloads/R1306CP.pdf on the CMS Web site.

If you have questions, please contact your Medicare FI at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site .

Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.

MLN Matters Number: MM5688
Related Change Request (CR) #: 5688
Related CR Release Date: July 20, 2007
Effective Date: October 1, 2007
Related CR Transmittal #: R1306CP
Implementation Date: October 1, 2007