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This annual proposed rule would update the payment rates used under the prospective payment system for SNFs for fiscal year 2024.  The rule also includes proposals for the SNF Quality Reporting Program (QRP) and for the Skilled Nursing Facility Value-Based Purchasing (VBP) Program that will affect Medicare payment to SNFs. In addition, this rule also proposes to establish new minimum staffing requirements that facilities must meet to ensure safe and quality care.

Statement of Need:

This proposed rule would update the SNF prospective payment rates as required under the Social Security Act (the Act). The Act requires the Secretary to provide, before the August 1 that precedes the start of each FY, the unadjusted Federal per diem rates, the case-mix classification system, and the factors to be applied in making the area wage adjustment.  

Summary of the Legal Basis:

In accordance with sections 1888(e)(4)(E)(ii)(IV) and 1888(e)(5) of the Act, the Federal rates in this proposed rule would reflect an update to the rates that we published in the SNF PPS final rule for FY 2023. These changes would be applicable to services furnished on or after October 1, 2023.

Alternatives:

None. This is a statutory requirement.

Anticipated Costs and Benefits:

Total expenditures will be adjusted for FY 2024.

Risks:

None.  The rule is necessary for SNF services to be paid appropriately.