On May 7, 2008, the Centers for Medicare & Medicaid Services is publishing its proposed fiscal year (FY) 2009 update to the Medicare skilled nursing facility (SNF) prospective payment system (PPS). Most notably, the proposed rule would recalibrate case mix weights to compensate for increased expenditures resulting from refinements made in January 2006. The recalibration would cut overall SNF PPS payments by 3.3% ($770 million) in FY 2009.  The decrease would be partially offset by a 3.1% market basket update, but SNFs would still see an overall cut in payments of $60 million, or 0.3%.  CMS will accept comments on the proposal until June 30, 2008.