Per the CMS final rule published November 9, 2012, any SNF Medicare bad debt not claimed with the 2012 Medicare cost report will only be reimbursable at 65% for private pays and 88% for copays of dual eligibles (those who also have Medicaid eligibility). This 88% percent will be further reduced in the next two years until it is phased in to only 65%.   This rule can be found at the 2012 Federal Register , pages 67518 and 67519. Page 67519 has a clear chart showing the reductions.