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CMS Tries Again: Another New Skilled Nursing Facility Medicare Reimbursement System Proposed If Implemented, Would Gut Therapy May 17, 2018 Proposed changes to nursing facility payment under consideration by CMS would reduce financial incentives to provide therapy, and would do so with such force providing higher reimbursement to skilled nursing facilities (SNFs) that provide residents fewer types of therapy over a shorter period of time, or no therapy at all that it would