The Center for Medicare & Medicaid Services (“CMS”) posted the annual update of the Post-Acute Care and Hospice Provider Public Use File (herein known as “PAC PUF”) with data for 2019 resulting in the PAC PUF now populated with data for years 2013-2019.
The PAC PUF presents summarized information on services provided to Medicare beneficiaries by home health agencies, hospices, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs).
The 2019 PAC PUF summarizes information on nearly 15 million claims and over $69 billion in Medicare payments for 2019. It contains information on 9,001 home health agencies, 4,584 hospices, 14,532 SNFs, 1,106 IRFs, and 358 LTCHs.
It contains information on demographic and clinical characteristics of beneficiaries served, professional and paraprofessional service utilization, submitted charges, and payments at the provider, state, and national levels. Additionally, the PAC PUF includes payment information at the payment system level for home health agencies, SNFs, and IRFs.
For 2019, CMS modified the data for SNFs presented in the PAC PUF. Specifically, SNF data are reported in a separate file and only cover the period between January 1, 2019 and September 30, 2019. CMS reports it adjusted the PAC PUF for SNFs because the SNF Prospective Payment System (PPS) changed from RUG IV to the Patient Driven Payment Model (PDPM) on October 1, 2019. To minimize confusion, CMS states it only reported data for RUG IV in the 2019 PAC PUF. CMS says it will incorporate data for the PDPM payment system in its next annual release of the PAC PUF.
In addition, beginning with the 2019 PAC PUF, CMS applied an updated crosswalk from the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality (AHRQ) to classify primary diagnoses using the Clinical Classifications Software Refined (CCSR) for ICD-10-CM version 2021.2. Previous releases of the PAC PUF used the Clinical Classifications Software (CCS) for ICD-10-CM/PCS (Beta More Read the supplemental Methodology document for more information.
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About the Author
Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years working as an on demand, special project, consulting, general counsel or other basis with domestic and international business, charitable, community and government organizations of all types, sizes and industries and their leaders on labor and employment and other workforce compliance, performance management, internal controls and governance, compensation and benefits, regulatory compliance, investigations and audits, change management and restructuring, disaster preparedness and response and other operational, risk management and tactical concerns.
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