CMS Announces New SNF Payment – On August 27, 2015, CMS announced “a new funding opportunity” for SNFs that is intended “to reduce avoidable hospitalizations by funding higher-intensity interventions in nursing facilities for residents who may otherwise be hospitalized upon an acute change in condition.”  The new funding is geared toward SNFs that participate in CMS’s Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.  According to CMS, for the past three years, CMS has partnered with seven Enhanced Care and Coordination Providers (ECCPs) to test a model to improve care for long-stay nursing facility residents.  CMS explained that under the “new four-year payment phase of the Initiative,” which should begin in October 2016, “[s]uccessful ECCP applicants would implement the payment model with both their existing partner facilities, where they provide training and clinical interventions, and in a comparable number of newly recruited facilities.”  Please click here to access CMS’s press release on the initiative.   

Proposed Lab Test Rule Under Review – The Office of Management and Budget (OMB) announced last week that it is currently reviewing CMS’s “economically significant” rule titled Medicare Clinical Diagnostic Laboratory Test Payment System (CMS-1621-P).  According to OMB, the proposed rule would require Medicare payment for clinical laboratory tests to be based on private payor rates beginning January 1, 2017, as required by section 216(a) of the Protecting Access to Medicare Act of 2014.