On December 9, 2010 the House of Representatives passed the Medicare and Medicaid Extenders Act of 2010.  A provision in this bill confirms the repeal of the RUG-IV payment system delay.  Skilled Nursing Facilities will continue to utilize the RUG-IV payment system which was initiated by CMS on October 1, 2010.  There is no longer a need for CMS to implement the Hybrid RUG-III grouper. The House vote was 409-2, following a unanimous vote by the Senate on December 8, 2010.  We are awaiting President Obama to sign the measure into law, which is expected. 

During the CMS Open Door Forum, December 9, 2010 Sheila Lambowitz, Director of the Division of Institutional Post Acute Care for the Centers for Medicare & Medicaid Services stated "We're not going to have to reprocess [RUG-IV] claims," "We're not going to have to change to a new [temporary]  grouper."  She went on to say that passage of the bill "gives us some clarity to move forward and work on transition issues and make sure we have the RUG-IV and MDS 3.0 system working properly."

Additionally this legislation extends Medicare's Therapy Cap Exception process until December 31, 2011. Therapy caps apply an annual cap per beneficiary on expenses incurred for both outpatient physical therapy and speech therapy services combined and a separate cap for outpatient occupational therapy services under Medicare Part B. For CY 2011, the therapy cap amount has increased slightly from $1,860 to $1,870. 

The Medicare and Medicaid Extenders Act of 2010 also eliminates the expected 25% reduction in Medicare payments to physicians that was to be initiated in January 2011.  This is great news for the LTC industry. 

"This agreement is an important step forward to stabilize Medicare, but our work is far from finished," President Obama said in a statement. He added that it's time "for a permanent solution that seniors and their doctors can depend on."

Additional information on this soon to be law can be obtained on the United States Senate Committee on Finance site: http://finance.senate.gov/legislation/details/?id=9f97aa2e-5056-a032-52d4-8db158b12b11