MDS Changes Raise Medicaid Payment Questions

The removal of a key section from the Minimum Data Set (MDS) will have massive repercussions, particularly for the future of nursing home reimbursements by states.

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The fate of Section G has been in question since the transition to the Patient-Driven Payment Model (PDPM), which made the section unnecessary from a Medicare reimbursement perspective. State-level Medicaid payments are another matter. Section G is used to calculate RUG scores that many states still use in determining reimbursement rates.

“It’s going to have a tremendous impact on our industry from a state-level reimbursement [perspective],” Gloria Brent, president and CEO of MDS Consultant LLC, told SNN.

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