CMS ‘Quiet’ on PDPM-Related Enforcement Even as Rates Rise, But Managed Care More Prone to Denials

The Patient-Driven Payment Model (PDPM), the overhaul to Medicare reimbursement for skilled nursing facilities that took effect in October of 2019, has proven its worth as a mechanism for paying for nursing care during a global pandemic. It has, however, been anything but revenue-neutral, at least in terms of how much money the government is spending on Medicare-covered stays in SNFs, Joel Wright, the vice president of operations at Therapy Management Corporation (TMC), said during an October 20 webinar.

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