October 1 marks the start of the new Medicare Patient Driven Payment Model (PDPM). We’ve gathered together resources to help ensure your facility is correctly and adequately reimbursed under this new system. AHCA also advises that the US Department of Veterans Affairs (VA) is not well prepared for implementation.

AHCA is aware of contracting issues in a handful of states (but not Virginia specifically). Out of an abundance of caution, AHCA is recommending that providers have their legal counsel carefully read any contracts or agreements with the VA before signing. If you have additional VA-related questions, contact AHCA’s Dana Ritchie. For PDPM and therapy related matters, contact AHCA’s Daniel Ciolek.

CMS Resources

• CMS Patient Driven Payment Model webpage (Updated materials say “(revision posted 8-30-19)” next to them.)
• MDS 3.0 RAI Manual v1.17.1 and MDS forms, effective October 1, 2019
  

AHCA Resources

• AHCA PDPM Resource Center
• AHCA Webinar: Week One of PDPM “One-Time” Transitional Policies 
• Access your facility’s personal Top-Line PDPM report. This report is a snapshot of previous coding practices for ICD-Coding on MDS assessments. Use this step-by-step guide to access your reports. 
• Make sure you know as much as possible about ICD-10 coding under PDPM. Check out the training sessions. One is an in-depth course for coders, and the other offers basic knowledge for non-coders. Both courses provide key information that will support a successful PDPM implementation.