Department of Health and Human Services, Centers for Medicare & Medicaid Services: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2013
GAO-12-998R, Aug 20, 2012
GAO reviewed the Department of Health and Human Services, Centers for Medicare & Medicaid Services' (CMS) new rule on Medicare program's prospective payment system and consolidated billing for skilled nursing facilities for FY 2013. GAO found that (1) the final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2013 as required under section 1888(e)(4)(E) of the Social Security Act, as amended (the Act). It also responds to section 1888(e)(4)(H) of the Act, which requires the Secretary of Health and Human Services to "provide for publication in the Federal Register" before the August 1 that precedes the start of each fiscal year, the unadjusted federal per diem rates, the case-mix classification system, and the factors to be applied in making the area wage adjustment used in computing the prospective payment rates for that fiscal year; and (2) CMS complied with applicable requirements in promulgating the rule.