SNF QRP and SNF VBP Claims-Based Measure Manual and Accompanying Files – Available

This document presents technical specifications for the production of Medicare fee-for-service (FFS) claims-based measures (CBMs) for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) and Value-Based Purchasing (VBP) program maintained by the Centers for Medicare & Medicaid Services (CMS). The measures are intended to promote informed decisions among Medicare …

FY 2025 SNF VBP Program December 2023 Quarterly Reports

The December 2023 Quarterly Confidential Feedback Reports for the fiscal year (FY) 2025 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are now available to download via the Internet Quality Improvement and Evaluation System (iQIES). These reports contain facility and stay-level data and results for the SNF 30-Day All-Cause Readmission …

CMS Health Equity Confidential Feedback Report Live Q&A

Video and transcript available This live Q&A session allowed participants to ask CMS subject matter experts about the methodologies and interpretations of the CMS Health Equity Confidential Feedback Reports for post-acute care (PAC) providers in the Home Health (HH), Inpatient Rehabilitation Facility (IRF), Long-Term Care Hospital (LTCH), and Skilled Nursing …

Medicare Expedited Determination vs. Financial Liability Notices: What’s the Difference?

Beneficiary notification requirements under the Medicare program can be confusing for nurse assessment coordinators (NACs) who serve as the lead Medicare nurse and other interdisciplinary team members in skilled nursing facilities (SNFs), says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC, director of education for Hansen, Hunter & Co. PC …

MDS Items Impacting Reimbursement for PDPM and SNF QRP – Updated Tool

Do you know what MDS items impact reimbursement under the Patient-Driven Payment Model (PDPM) or the Skilled Nursing Facility Quality Reporting Program (SNF QRP)? Use this quick guide, MDS Items Impacting Reimbursement for PDPM and SNF QRP, for easy reference to get your payment straight. This AAPACN resource is copyright …

MLN Network Provider Minute Video: The Importance of Proper Documentation

This video will help providers and physicians understand the need and importance of medical record documentation to support the services billed. Watch this video to learn more about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the …

At-a-Glance QM, QRP, and VBP Tool

With so many Quality Measures originating from three different payment initiative programs, it’s a lot to keep track of. AAPACN’s At-a-Glance QM, QRP, and VBP tool organizes all of the measures for you. This tool has been updated with the MDS 3.0 Quality Measures User’s Manual Version 16.0 (September 2023) the Five-Star …

PDPM Grouper Update

The “PDPM Grouper JAR Package V2.2001.zip” is now available. This V2.2001 release is an update to adjust the OBRA logic for target dates on or after October 1, 2023.    The logic for standalone OBRA assessments will be similar to the interim payment assessments logic. This means that:      If A0310A=01 and A0310B=99, …

2025 Medicare Advantage Proposed Rule Includes Some SNF-Related Proposals

Biden-Harris Administration Proposes to Protect People with Medicare Advantage and Prescription Drug Coverage from Predatory Marketing, Promote Healthy Competition, and Increase Access to Behavioral Health Care in the Medicare Advantage Program Fact sheet Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Plan Program, Medicare Prescription Drug Benefit …

CY 2024 Final Physician Fee Schedule and Other Part B Proposals

Nov 02, 2023  https://www.cms.gov/newsroom/press-releases/cms-finalizes-physician-payment-rule-advances-health-equity Final policies will expand behavioral health services, advance the President’s Cancer Moonshot, support family caregivers, and accelerate value-based care The Centers for Medicare & Medicaid Services (CMS) announced it is finalizing policies to support primary care, advance health equity, assist family caregivers and expand access to behavioral …