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Finally final. HCFA's final rule governing the SNF PPS was published on July 30 and takes effect on September 28. Among its points:

* HCFA will match the UB-92 to the MDS and generate reports for use by fiscal intermediaries during medical review of bills. FIs will focus on consistency between the MDS and the rest of the medical record.

* PPS will not cover "non-skilled" residents just because they are included in one of the "top 26" RUGs. From admission through the five-day reference date, however, a resident in the top 26 RUGs may be presumed eligible,

* While noting that the Balanced Budget Act forbade fundamental changes in payment methodology or rate structure, HCFA sald it is looking into "medication therapy, medically complex patients, and other non-therapy ancillary services" and considering "potential refinements to the case-mix model."
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Publication:Contemporary Long Term Care
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 1999
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