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医疗保险计划;2016财年熟练护理设施(SNFs)的前瞻性支付系统和合并计费、SNF基于价值的采购计划、SNF质量报告计划以及人员配置数据收集。最终规则。

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs) for FY 2016, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and Staffing Data Collection. Final Rule.

出版信息

Fed Regist. 2015 Aug 4;80(149):46389-477.

Abstract

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it specifies a SNF all-cause all-condition hospital readmission measure, as well as adopts that measure for a new SNF Value-Based Purchasing (VBP) Program, and includes a discussion of SNF VBP Program policies we are considering for future rulemaking to promote higher quality and more efficient health care for Medicare beneficiaries. Additionally, this final rule will implement a new quality reporting program for SNFs as specified in the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). It also amends the requirements that a long-term care (LTC) facility must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program, by establishing requirements that implement the provision in the Affordable Care Act regarding the submission of staffing information based on payroll data.

摘要

本最终规则更新了2016财年熟练护理机构(SNF)在预期支付系统(PPS)下使用的支付费率。此外,它规定了一项SNF全因全病症医院再入院指标,并将该指标用于新的SNF基于价值的采购(VBP)计划,还包括对我们正在考虑用于未来规则制定的SNF VBP计划政策的讨论,以促进为医疗保险受益人提供更高质量和更高效的医疗保健。此外,本最终规则将实施2014年《改善医疗保险后期护理转型法案》(IMPACT法案)规定的针对SNF的新质量报告计划。它还修订了长期护理(LTC)机构必须满足的要求,以便有资格作为熟练护理机构(SNF)参与医疗保险计划,或作为护理机构(NF)参与医疗补助计划,通过确立实施《平价医疗法案》中关于根据工资数据提交人员配置信息的条款的要求。

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