Blog 
Click here to go back
Resources: Proposed Tax Relief Bill, Screening Risk Change for Skilled Nursing Facilities and Hospice Providers and Medicaid Therapy Reimbursement Changes
Proposed tax relief bill disallows ERC after January 31
The proposed Tax Relief for American Families and Workers Act of 2024 includes disallowing employee retention credit (ERC) claims filed after Jan. 31, 2024. The ERC provision will offset other items in the bill including restoring Sec. 174 (R&E) expensing, enhancements to the child tax credit and other tax relief provisions. It will also allow the IRS to take meaningful action against the pervasive fraud that has plagued the ERC program. While there is a chance that this tax package will not pass and be signed into law, members may want to consider filing any outstanding claims immediately since there is enough Congressional concern about the ERC program that lawmakers could pass a stand-alone bill to end the program early.
Notice of Screening Risk Change for Skilled Nursing Facilities and Hospice Providers
For Skilled Nursing Facilities:
Kentucky Medicaid has been notified of a screening risk level change in 42 C.F.R. § 424.518. for Skilled Nursing Facilities (SNFs) effective Jan. 1, 2023.
As of Jan. 1, 2023, SNFs enrolling or undergoing a change in ownership were elevated from the “limited” level of categorical screening to the “high” screening level. The final rule effectuating this change was published in the Federal Register on Nov. 18, 2022
For Hospice Providers:
Kentucky Medicaid has been notified that effective Jan. 1, 2024, newly enrolling hospices have been elevated from the “moderate” to the “high” screening level.
As of Jan. 1, 2024, Hospice providers enrolling or undergoing a change in ownership shall be elevated from the “limited” level of categorical screening to the “high” screening level. The final rule effectuating this change was published in the Federal Register on Nov. 13, 2023
Additional details can be found on the Department for Medicaid Services website.
Change to Medicaid Therapy Reimbursement for Medicaid Only Patients
Medicaid reimburses therapy and laboratory/radiology services separately for Medicaid only patients (patients without Medicare B). Department for Medicaid Services (DMS) is tentatively planning to cease reimbursing therapy separately and include therapy as a line item in the 7/1/24 SNF rate.
This will be advantageous for SNFs in several ways.
1. Medicaid can pay higher overall rates. The inclusion of therapy increases the Upper Payment Limits.
2. SNFs will no longer have to bill Medicaid for therapies.
3. SNFs will no longer have to obtain therapy prior authorizations.
Tentatively, the therapy component included in the 7/1/24 Medicaid rate will be based on prior years therapy claims submitted. Starting with the 2024 cost report submission, SNFs will report the therapy given to Medicaid only patients by therapy discipline, by HCPC, and by month.
Please watch for further updates as the changes become available.
