Reimbursement

  • SNF PDPM Basics an Impacts in Care Delivery Partners Toolkit

    Contains 1 Component(s)

    ​Because CMS has provided limited to no guidance to SNF care delivery partners impacted by the PDPM implementation on October 1, AHCA members have asked if we could create a webinar about PDPM that providers could share with referring hospitals, physicians, Medicare Advantage plans, Accountable Care Organizations, and Bundled Payment program partners. To help facilitate AHCA member discussions with care delivery partners about PDPM, we have prepared a one page document that includes links to the following five pre-recorded webinars and slides that are intended to be viewed by SNF care delivery partner to get a better understanding about what PDPM is, and how PDPM may impact their relationships with SNF providers.

  • CMS PDPM-Related PDPM/MDS/SNF QRP Resources

    Contains 62 Component(s)

    On May 7-8, 2019 and again (with minor updates) on August 13-14, 2019 the Centers for Medicare and Medicaid Services (CMS) conducted a two-day train-the-trainer session on the October 1, 2019 updates to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). Examples of agenda items directly relevant to PDPM include: discussions on how to properly code Section GG of the MDS, Changes in Sections A, I, J, and O of the MDS, PDPM: What is changing and what is not, and Integrated coding & PDPM Case Study. This PDPM Academy toolkit includes all available CMS agenda, slides, and video resources related to these training dates. Additionally, this toolkit contains a direct link to the CMS PDPM-Related MDS-RAI Resources webpage containing the most current minimum data set resident assessment instrument (MDS-RAI) manual. Scroll to the bottom of the page and download the file under “Related Links” labeled MDS 3.0 RAI Manual v1.17 October 2019.

  • CMS MDS Section GG Training Resources

    Contains 5 Component(s)

    The SNF PPS Patient Driven Payment Model (PDPM) relies on accurate coding of several MDS Section GG mobility and self-care items that impact the PT, OT, and Nursing component per-diem case-mix payment rates. This toolkit contains a collection of Section CC training materials that the Centers for Medicare and Medicaid Services (CMS) has provided on their website that may be useful for provider PDPM training of nurses, certified nursing assistants, and therapists.

  • Quality Initiatives in Medicaid

    Contains 3 Component(s)

    Our quality-focused webinar will discuss quality initiatives in Medicaid. Included will be potential performance measure development in both fee-for-service and managed care environments. This webinar will also include Value-Based Purchasing, and the technical assistance AHCA/NCAL can provide.

  • Medicaid Financing

    Contains 1 Component(s)

    The purpose of this webinar is to map out the basics of how Medicaid is financed, including different opportunities states may pursue and state Medicaid matching pressures. It will include information on the Federal Medical Assistance Percentage (FMAP) and state match rates, provider taxes, intergovernmental transfers (IGTs), upper payment limits (UPLs) as well as supplemental payments.

NCAL AHCA