Published July 26, 2018

Skilled Nursing Facilities not compliant with the Quality Reporting Program (QRP) requirements will be receiving a 2% reduction in their Annual Payment Update (APU) beginning Fiscal Year 2018 and each subsequent rate year moving forward.

Facility’s subject to this reduction received their non-compliance letters from the Medicare Administrative Contractors (MAC’s) earlier this month via USPS. Written notification is also available through the QIES system. Be sure to read these letters carefully! They include the rationale for the payment reduction, steps to take to submit a request for reconsideration and the deadline for request submission. See sample letter below.

What should you do now?

• Access folders in the QIES system to ensure you are not subject to this payment reduction.
• If you received a reduction notice, access your QRP Review and Correct reports for January 1, 2017 through December 31,2017 to validate the determination.
• If you find the reduction notice was issued in error, submit your reconsideration request by the August 7th deadline.
• Submission will be accepted via email only.

What you should consider moving forward!

The data correction deadline for Q1 2018 QRP data is August 15th. Access your Review and Correct reports from the QIES system to be sure you exceed the 80% threshold. Those facilities who fall below the threshold will be subject to further payment reduction for FY 2020.

Consider including the Review and Correct reports in your quarterly QAA and QAPI program to ensure routine surveillance and process improvement implementation if necessary.

Information on QRP can be accessed on the CMS website. For support or education on QRP, please feel free to contact us!

Sarah Ragone, MSPT, RAC-CT
VP of Reimbursement & Education