Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Legislative History

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The afternoon of February 24, 2021, CMS posted this updated SNF PPS Legislative History document.  I stumbled upon this document when looking for the updated FY 2021 PDPM ICD-10 Mappings for another project.  I have not seen such a document before so after review, I decided to share it with our readers as well.  The document (9 pages) reports the update as of January 26, 2021; when saving the document, a date of January 20, 2021 is visible.

“Historically, each rule or update notice issued under the annual Skilled Nursing Facility (SNF) prospective payment system (PPS) rulemaking cycle included a detailed reiteration of the various individual legislative provisions that have affected the SNF PPS over the years, a number of which represented temporary measures that have long since expired. This document now serves to provide that discussion.”

It is an interesting, historical review.  The document summarizes these pieces of legislation and includes hyperlinks for more information:

  • Current System for Payment of Skilled Nursing Facility Services Under Part A of the Medicare Program
    • Rates
    • Transition
    • Coverage
    • Consolidated Billing
    • Payment for SNF-Level Swing-Bed Services
    • Availability of Wage Index Values
  • Requirements of the Balanced Budget Act of 1997 (BBA) for Updating the Prospective Payment System for Skilled Nursing Facilities
  • The Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA)
  • The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA)
  • The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
  • The Affordable Care Act
  • Protecting Access to Medicare Act (PAMA)
  • Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act)
  • Legislative History of SNF Consolidated Billing