Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026 CMS-1835-P
Summary
This proposed rule updates how Medicare pays skilled nursing facilities (places where people recover after hospitalization) and changes which quality measures these facilities must report to the government. The changes aim to improve care quality and ensure Medicare payments fairly reflect the services provided.
Key Points
- 1Updates payment rates and formulas for skilled nursing facilities for fiscal year 2026
- 2Modifies quality reporting requirements so facilities must track and report different performance measures to Medicare
- 3Affects nursing homes and rehabilitation centers that care for Medicare patients recovering from surgery or serious illness
- 4Allows the public to comment on the proposed changes until May 22, 2025 before the rule becomes final
- 5Aims to improve patient care quality while adjusting how much Medicare reimburses facilities for services
Impact Assessment
If you are a skilled nursing facility operator, this means you'll need to adjust billing practices, implement new quality reporting measures, and potentially modify operations to comply with updated Medicare payment formulas and quality standards.
National
Moderate
Key Dates
September 8, 2025
Regulatory Connections
Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction
Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements CMS-1835-P. Display CMS-1835-P
This summary is for informational purposes only. It may not capture all nuances of the regulation. Always refer to the official text for authoritative information.
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