CMS Proposed Rule to Redefine Group Therapy in Skilled Nursing Facilities: Concern for Resident Care

On April 25, 2019, the Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking (NPRM) on fiscal year 2020 payment and policy changes for Medicare-certified skilled nursing facilities. Most notably, the proposed rule projects an $887 million increase in aggregate payments to SNFs and revises the definition of group therapy to allow a single therapist to work with six residents at oe time instead of four residents, as is currently allowed. Comments on the proposed rule are due June 18, 2019.

The Center for Medicare Advocacy is troubled by CMS’s decision to redefine group therapy in this manner. The proposed revision, when examined in light of other related policies, suggests that facilities will have an even greater financial incentive to forgo individual therapy in favor of less costly, often less effective, group therapy sessions. The Center will be submitting comments detailing our concerns before the deadline. We urge others to do so as well, and let us know if we can help.

To read the proposed rule, please visit: https://www.govinfo.gov/content/pkg/FR-2019-04-25/pdf/2019-08108.pdf