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Skilled Nursing Facility (SNF) Value-Based Purchasing Program VBP

The SNF VBP program is a pay-for-performance program. As required by statute, CMS withholds 2% of SNFs’ Medicare fee-for-service (FFS) Part A payments to fund the SNF VBP Program. This 2% is referred to as the “withhold”. CMS is then required to redistribute between 50% and 70% of this withhold to SNFs as incentive payments depending on their performance in the program.

CMS is proposing several operational and administrative proposals as part of this year’s rule. Operationally, CMS is proposing the adoption of a measure retention and removal policy. CMS is also proposing updating the case-mix methodology for the Total Nurse Staffing measure and a review and correction policy update.

Nursing home providers should note that the fiscal 2025 SNF PPS proposal is up for public comment right now through May 28, CMS officials said.

Click here to visit the CMS website to learn more.

Personal Needs Allowance Increase at 7/1/24

As part of House Bill 6, Medicaid is increasing the Personal Needs allowance from $40 to $60. Below is the wording from the House Bill.

(24) Personal Needs Allowance: Included in the above General Fund 5 appropriation is $3,775,000 in each fiscal year to increase the Personal Needs Allowance 6 from $40 to $60 per month effective July 1, 2024. Notwithstanding KRS 45.229, any 7 portion of General Fund not expended for this purpose shall lapse to the Budget Reserve 8 Trust Fund Account (KRS 48.705). Mandated reports shall be submitted pursuant to Part 9 III, 24. of this Act.