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NHF Submits Recommendation to CMS on Factor Reimbursement

As part of ongoing revisions to almost all of its systems for reimbursement since passage of the Medicare Modernization Act of 2003, the Centers for Medicare and Medicaid Services (CMS) is currently considering new rules for how patient services are reimbursed at skilled nursing facilities (SNFs). Under the current system, SNFs receive a much lower rate of reimbursement by CMS for clotting factor. As a result, some facilities are reluctant or even unwilling to accept patients with bleeding disorders for fear of having to absorb substantial factor costs.

The reasons why patients with bleeding disorders might need to enter a SNF would be upon release from a hospital following surgery or for rehabilitation after a debilitating illness.

NHF believes the reimbursement for clotting factor at skilled nursing facilities is inadequate. In response, NHF submitted a letter to CMS from CEO Alan J. Kinniburgh, Ph.D., requesting that the new rules rectify this problem by more adequately reimbursing for factor administered in the SNF setting, just as it does for factor that is administered in almost every other setting. (CLICK HERE TO VIEW A COPY OF NHF'S COMMENTS TO CMS). NHF will continue to provide updates on these changes and other changes to how reimbursement is handled by both public and private payers.


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