This document supplements previous reporting information issued in July and revised August. 14.
As part of the required reports, providers must report certain data for 2019 and 2020:
To be eligible for an incentive payment, nursing homes “must have an active state certification as a nursing home or skilled nursing facility (SNF) and receive reimbursement from the Centers for Medicare & Medicaid Services (CMS).” In addition, they will need to pass through both of the following “gateways”:
The performance-based incentive payments represent $2 billion of the $5 billion SNF Infection Control Distribution from the Provider Relief Funds.
HHS will measure nursing homes on two outcomes:
HHS indicates that it considers the term "assited living facility" to include those providers who are state-licensed or certified and provide assisted living-type services even if the state doesn't call them "assisted living."
As a reminder, in mid-August, HHS modified which providers are eligible to apply for the Phase 2 General Distribution to include not only the Medicaid, CHIP and dental providers but also clarified and added the following:
It’s official HHS has opened the Provider Relief Funds application process to the following Medicare providers (this list includes some newly eligible categories of providers):
These letters notifying providers of noncompliance with QRP are distributed to SNFs in at least one of three possible ways: 1) through the Medicare Administrative Contractors (MACs); 2) placed in a provider’s CASPER folders in QIES; and/or a 3) Via U.S. Postal Service. Providers deemed noncompliant will see their Medicare Fee For Service rates reduced 2% beginning October 1, 2020.
The Feb 20 proposed rule, if finalized, will extend the CJR Model through December 31, 2023 for certain participating hospitals and proposes to expand the eligible procedures to include certain outpatient hip and knee replacement procedures. The CJR model is currently scheduled to end December 31, 2020. The rule also seeks to refine aspects of the model such as target pricing, risk adjustment, reconciliation process, and eliminating the current 50% cap on gainsharing with physicians and non-physician practitioners.
With the recent announcement of an application portal for Medicaid and CHIP providers to apply for a Targeted Medicaid distribution from the Provider Relief Fund, LeadingAge sought to clear up the confusion around this particular distribution.
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