RUG-IV Now on the Back Burner Until 2011

The new healthcare reform package will push back the RUG-IV classification system's implementation until October 1, 2011.

RUG-IV, or Resource Utilization Group, Version Four, is a revised case-mix classification model. Medicare uses the case-mix classification system to assign nursing home residents to categories based on their medical conditions and the resources that are needed to care for them. Each category is tied to a specific Medicare payment rate.

A few of the changes that will be included in RUG-IV include:

• An increased number of RUG categories (from 53 to 66)
• The Special Care category will be split into Special Care High and Special Care Low
• The Impaired Cognition and Behavior categories will be combined to form one category: Behavioral Symptoms and Cognitive Performance
• Revisions to calculations of therapy minutes

To learn more about the changes that will come with RUG-IV, click here.

Healthcare reform will also retain the Medicare market basket, delay a "productivity adjustment" to provider reimbursements and extend the Medicare Part B therapy caps exceptions process through December 31 of 2010. It also establishes payment bundling pilot programs, requires disclosure of nursing home ownership, increases civil monetary penalties against nursing homes, establishes an independent Medicare payment advisory board and implements the CLASS (Community Living Assistance Services and Supports) Act.