CMS Releases Proposed 2016 Fiscal Rule

Carl J. Pucci in Finance & Reimbursement

CMS has released its proposed 2016 Fiscal Rule for Skilled Nursing Facilities.  Initial analysis from AHCA indicates a 1.4% increase to SNF PPS rates, effective 10/1/15.  (Approximately $500 million nationwide.)  The 1.4% increase is net of ACA mandated reductions, as well as CMS forecast error corrections.  Please note the AHCA bulletin for further details.

NYSHFA will review the CMS proposed rule in detail, and once finalized by CMS, will calculate facility 2015/16 PPS rates sometime in early summer.

Note:  Last year’s 2014/15 PPS Fiscal Rule initiated a wage index adjustment, which has a two-year phase in.  Thus providers who experienced either different Core-Based Statistical Areas (CBSAs) or revised wage indexes will be 100% phased in this coming federal fiscal year.  (vs. a current 50/50 blended rate.)  These adjustments will again be referenced once the Fiscal Rule is finalized and PPS rates are calculated.


Carl J. Pucci
Director, Finance & Reimbursement
518-462-4800 x36