Latest Regulatory Updates for Skilled Nursing Facilities

See the latest SNF related updates as of July 27, 2020. These include information on the Public Health Emergency Extension, Quality Reporting, Interrupted Stay Billing, Resources, and ABN Reminders
July 28, 2020
Regulatory
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Extension of the Public Health Emergency

On Wednesday, July 23rd, Secretary Azar of the Department of Health and Human Services renewed the Public Health Emergency (PHE). The PHE originally began on January 27th and was extended in April. This latest extension allows the PHE to remain in place until October 23, 2020, another 90 days.

The extension of the Public Health Emergency allows the 1135 waivers to continue.To review the blanket waivers and flexibilities in place secondary to Coronavirus and the Public Health Emergency, please follow the link: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers

SNF Quality Reporting

The SNF Quality Reporting Program (QRP) non-compliance letters for the FY 2021 Annual Payment Update (APU) are in the process of being distributed by the Medicare Administrative Contractors. Notification may be received via mail or via the facilities CASPER folders in QIES.  These were placed in QIES as of July 13th.  

The facility may request reconsideration upon receiving notification of non-compliance.  Requests for reconsideration for the SNF QRP must be sent to CMS via e-mail by 11:59 p.m. on August 18th, 2020.  The e-mail address to submit a request is SNFQRPReconsiderations@cms.hhs.gov.

If the facility does not receive notification via mail or via the CASPER system, then there will be no APU reduction.  If the facility does receive notification,the APU reduction will take effect as of October 1, 2020.

 

SNF Interrupted Stay Billing

CMS has indicated an issue with billing an interrupted stay at the end of the month.  Per CMS, an edit(U5601-U5608) has been incorrectly assigned. This edit indicates an overlap with a hospital claim.  For the provider to bill the interrupted stay correctly, billing must go past the last day of the interrupted stay.  CMS indicates the provider must adjust the statement covered from and through dates. The provider must either:

     1. Bill a month plus the days in the subsequent month, which include the interrupted stay plus 1 day; OR

     2. Bill 2 months at a time (for the month encompassing the interrupted stay)

While CMS intends to correct this issue, they note providers will need to cancel paid claims and all subsequent claims in the same stay and resubmit in sequential order.  Hospitals are asked to reach out to SNFs to modifier their claims if an inpatient hospital claim is rejected. This will need to continue until October 5th.

 

Administration Announcements regarding resources for Nursing Homes

President Trump announced on Wednesday, July 23rd, HHS will be devoting $5 billion of the Provider Relief Fund from the CARES Act to Medicare certified long-term care facilities and state veterans’ homes.  Nursing Homes will be required to participate in online, self-paced training modules related to COVID-19 with emphasis on infection control and best practices. The trainings were created in partnership with the CDC.

The monies received are to assist with staffing, obtaining resources,as well as to pay for testing.  This is in addition to the testing units and 400 test kits to be sent to each facility.

Other efforts include:

·     Enhanced testing– Nursing homes in states with a 5% positivity rate or greater are to test staff each week

·     Additional technical assistance and support – Federal Task Force Strike Team to provide onsite technical assistance and education

·     Provision of weekly data on high risk nursing homes – CMS will release list of nursing homes with cases to be sent to states as part of the Governor’s report to allow states to target their support to high risk nursing homes

Here is a link to the press release from CMS: https://www.cms.gov/newsroom/press-releases/trump-administration-announces-new-resources-protect-nursing-home-residents-against-covid-19

 

ABN Reminder

As a reminder CMS’ new ABN form must be used starting this month,August 2020. While there are no significant changes to the content of the form,the expiration date has been updated to June 30th, 2023.  Provided is a link to the new forms: https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN