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Notice of Conversion to PDPM rates.
Payment is issued IAW will use the Patient Driven Payment Model (PDPM) as the pricing method for new IDIQ contracts. VHA will also propose to modify current contracts in effect after September 30, 2025 to use PDPM. PDPM was introduced by Centers for Medicare and Medicaid Services (CMS) in 2019 and some states have adopted PDPM. CMS stopped supporting the Resource Utilization Groups (RUG) rates on in 2020. The temporary exceptions to this change are contracts awarded for Alaska and Oregon or awarded to a Medicaid-only nursing home in a state that has not yet converted to PDPM.
Future contract prices and modified contract prices using PDPM will follow the same fee schedule used for Veterans Care Agreements (VCA). These rates are set nationally and published at https://www.va.gov/COMMUNITYCARE/revenue-ops/Fee-Schedule.asp. VHA will no longer negotiate rates. VHA will provide PDPM claims assistance during the transition.