A first step toward recognition by Congress that they forgot outlier protections when 
they passed SNF PPS!

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Orth, Ron A
Sent: Wednesday, May 12, 2004 4:16 PM
To: '[EMAIL PROTECTED]'
Subject: Increase in Reimbursement -AIDS Residents


Did you know that effective Oct 1, 2004, CMS will increase the payment for
AIDS patients by 128%!!!.  

This is part of the Medicare Modernization Act signed earlier this year.

SEC. 511. PAYMENT FOR COVERED SKILLED NURSING FACILITY SERVICES.
(a) ADJUSTMENT TO RUGS FOR AIDS RESIDENTS.-Paragraph
(12) of section 1888(e) (42 U.S.C. 1395yy(e)) is amended to read
as follows:
''(12) ADJUSTMENT FOR RESIDENTS WITH AIDS.-
H. R. 1-234
''(A) IN GENERAL.-Subject to subparagraph (B), in the
case of a resident of a skilled nursing facility who is
afflicted with acquired immune deficiency syndrome
(AIDS), the per diem amount of payment otherwise
applicable (determined without regard to any increase
under section 101 of the Medicare, Medicaid, and SCHIP
Balanced Budget Refinement Act of 1999, or under section
314(a) of Medicare, Medicaid, and SCHIP Benefits Improvement
and Protection Act of 2000), shall be increased by
128 percent to reflect increased costs associated with such
residents.
''(B) SUNSET.-Subparagraph (A) shall not apply on
and after such date as the Secretary certifies that there
is an appropriate adjustment in the case mix under paragraph
(4)(G)(i) to compensate for the increased costs associated
with residents described in such subparagraph.''.
(b) EFFECTIVE DATE.-The amendment made by paragraph (1)
shall apply to services furnished on or after October 1, 2004.


For more information click here
http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/MM3291.pdf

Ronald A Orth, RN, NHA, RAC-C
National Director of Clinical Reimbursement
Extendicare Health Services, Inc.
(414) 908-8234

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The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
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         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
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