Avoid Potential 2% Reduction on Medicare Fee for Service Rates

Posted on April 30, 2019 by Julie Apold

The next submission deadline for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) is fast approaching. MDS data for Oct. 1 – Dec. 31, 2018 must be submitted no later than 11:59 p.m. Pacific Standard Time on May 15.  

It is highly recommended that all SNF providers access the new SNF QRP Provider Threshold Report in the CASPER system that shows, by measure, whether they are sufficiently reporting MDS data. 

To satisfy the requirements of the SNF QRP, SNFs must report 100% of the required MDS items at least 80% of the time. When a SNF falls below that 80% requirement for CY2018 MDS data, it is in jeopardy of having its FY2020 (begins October 1, 2019) Medicare FFS rates reduced by 2%, even in cases where a SNF only misses the reporting threshold on 1 of the 8 MDS-based measures.

Last year, some SNFs experienced a 2% cut due to MDS data containing dashes in key Section GG fields and being deemed non-reporting.

LeadingAge believes SNFs are in the most jeopardy of insufficient reporting on the four new measures that CMS began tracking on Oct. 1, 2018 (during the Q4 reporting period):

• Change in Self-Care Score (NQF#2633)
• Change in Mobility Score (NQF#2634)
• Discharge Self-Care Score (NQF#2635)
• Discharge Mobility Score (NQF#2636)

SNFs can correct MDS submissions for the Q4 MDS data if the corrections are completed and submitted no later than the May 15 deadline.