As proposed back in May, Medicare rates for nursing facility services have been increased by $690 million, or 3.3%, in total, for FFY 2008.  The Medicare final rule went on display yesterday and is to be published in the Federal Register August 3.

Per the state budget, Massachusetts Medicaid rates for SNFs have been increased by $80 million, or 4% on average, for SFY 2008, through emergency regulations promulgated last week.

So far, so good.  The regulations are simply implementing legislative rate adjustment principles.

Well, not so fast:  Those principles are hardly written in stone.  Congress currently seems hell-bent on monkeying with all sorts of things as the SCHIP reauthorization bill, now known (in the House) as the Children’s Health and Medicare Protection Act of 2007 (CHAMP Act), rolls along.  The industry association, AHCA, observes that the CHAMP Act, now in House Ways & Means, includes a cut of $2.7 billion over five years for Medicare services to seniors in nursing facilities.  This follows up on our fearless leader’s (DOA) proposed five-year, $2.8 billion Medicare nursing facility payment cut in his FFY 2008 budget, based on a negative inflation factor.

So NF reimbursement looks stable, back on the upswing, even — but only so long as the basic rules don’t get changed. 

Unfortunately, while health care seems to have the nation’s attention, nobody seems to want to pay for it; talk of negative inflation factors trigger outpourings of invective from the provider communities (cf. the SGR issue for docs), but nobody else seems to care enough to sit down and work hard at structural change.

David Harlow