CMS Boosts SNF Rates in Proposed PPS for FY 2026

The skilled nursing industry was elated by the Centers for Medicare and Medicaid Services (CMS) proposed Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, which included a 2.8% pay bump for FY 2026 and some other breaks that could reduce SNF costs.

The rate hike falls far short of the 4.2% raise that SNFs received this year and the 4% increase the year prior, but the industry was thrilled with the announcement nonetheless. According to McKnights, SNFs now have some wiggle room with a bump in Medicare reimbursement, but the largest source of income for the industry, Medicaid, is currently on the chopping block in Congress. From Clif Porter, president and CEO of the American Health Care Association/National Center for Assisted Living:

While the proposed  payment update focuses on Medicare fee-for-service rates, let’s remember that nearly two-thirds of nursing home residents rely on Medicaid, and an increasing percentage of short-term patients are now on a Medicare Advantage plan. … the nation’s leaders must ensure that our Medicare and Medicaid programs are strong.

Inside Health Policy notes that the rule also eliminates policies from the Biden administration related to social determinants of health (SDOH) and health equity. According to the administration, the elimination of these requirements would save facilities a combined $2.2 billion. CMS also requests stakeholder feedback on requests related to the quality reporting program (QRP).

The full rule can be reviewed at the CMS Newsroom.