3 Day Stay Waivers end May 11, 2023
The end of the COVID-19 public health emergency (PHE) is May 11, 2023. For resident admissions prior to May 11, 2023, the 3 Day waiver can still be utilized with condition code DR. All admissions after May 11, 2023, will be required to have a 3 day hospital stay to be reimbursed.
Kentucky Medicaid $270 Add-On
Due to the Public Health Emergency (PHE) ending, the last date of service for Revenue Code 550 ($270 COVID-19 add on reimbursement) will be May 11, 2023. As of May 12, 2023, claims with Revenue Code 550 will not be paid and providers may need to split the bill for May dates of service.
Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1779-P)
On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2024. In addition, the proposed rule includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program for FY 2024 and future years. CMS estimates that the aggregate impact of the payment policies in this proposed rule would result in a net increase of 3.7%, or approximately $1.2 billion, in Medicare Part A payments to SNFs in FY 2024.
Center of Excellence for Behavioral Health in Nursing Facilities
On the April 13, 2023 CMS SNF/LTC Open Door Forum, an overview of the Center of Excellence for Behavioral Health in Nursing Facilities was shared. We encourage you to review their website and available resources.
CERT Review Contractor name change
The Comprehensive Error Rate Testing (CERT) Review Contractor, formerly known as NCI Information Systems, Inc. changed their company name to Empower AI, Inc.
Advance Beneficiary Notice of Noncoverage: Form Renewal
The Office of Management and Budget approved the Advance Beneficiary Notice of Noncoverage (Form CMS-R-131) for renewal. This renewed form expires January 31, 2026. The expiration date is the only change to the form. You may use the renewed form now, but you must use it beginning June 30, 2023, when the previous version expires.
Kentucky Medicaid Renewal Report
As of April 30, 2023, Kentucky nursing facilities and intermediate care facilities will be able to generate a Medicaid Renewal Report listing all individuals with Medicaid Eligibility that are due for Medicaid Renewals.