Southwest Consulting Associates Blog

Kyle Pennington

Kyle currently leads SCA’s Medicare DSH & S-10 Uncompensated Care national sales efforts and is instrumental in cultivating and managing business relationships with SCA clients. In addition to his sales and client relation functions, Kyle has previously served SCA in operations management roles.
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Recent Posts

FY19 IPPS Final Rule: Cost Report Worksheet S-10 Is Here To Stay

Posted by Kyle Pennington on Oct 12, 2018 1:32:37 PM

The Fall 2018 issue of HFMA New Jersey's Garden State FOCUS magazine included an article titled, "FY 2019 IPPS Final Rule Update: Worksheet S-10 Is Here To Stay" which takes a look at:

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Topics: Medicare DSH Reimbursement, final rule, worksheet s-10, S-10, regulations

Worksheet S-10: 2017 History and Resource Guide

Posted by Kyle Pennington on Mar 4, 2018 2:38:00 PM

It was an eventful 2017 for CMS when it came to Worksheet S-10 and while we blogged on each milestone individually, we thought a resource summarizing EVERYTHING that took place last year regarding S-10 would be helpful for reference.  So let's waste no time and review the S-10 2017 "appearances" starting with how Medicare cost report Worksheet S-10 rose to fame.

 

April 28, 2017 - CMS posts the FFY 2018 IPPS Proposed Rule

    • For FFY 2018, CMS again proposed to begin utilizing uncompensated care data from Worksheet S-10 to calculate qualifying providers’ Factor 3.

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Topics: S-10

Worksheet S-10 Q&A Posted by CMS

Posted by Kyle Pennington on Jan 5, 2018 1:54:05 PM

The Centers for Medicare and Medicaid Services (CMS) has posted a Questions and Answers document providing clarification related to Medicare Cost Report Worksheet S-10.  If you’ll recall, CMS issued Transmittal 11 in September 2017 that made a number of revisions to the instructions for reporting data on cost report Worksheet S-10.

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Topics: worksheet s-10, uncompensated care, Medicare DSH Reimbursement

CMS Issues Transmittal 1981, Change Request 10378 for Worksheet S-10

Posted by Kyle Pennington on Dec 5, 2017 1:48:29 PM

On Friday, December 1, 2017, CMS released Transmittal 1981, which clarifies the deadlines for uploading revised or initial submissions of FY 2014 and FY 2015 cost report Worksheet S-10.  For revisions to be considered, CMS extended the deadline to Tuesday, January 2, 2018, for all IPPS hospitals to submit the data to their Medicare Administrative Contractor (MAC).  On December 4, 2017, the provider education article, MM10378, was released related to this instruction.

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Topics: worksheet s-10, CMS transmittal

CMS Posts FY2014 Worksheet S-10 Revisions Announcement

Posted by Kyle Pennington on Jul 13, 2017 5:44:09 PM

 

On Thursday, July 13, 2017, CMS announced that “amended FY 2014 cost reports due to revised or initial submissions of Worksheet S-10 received by Medicare Administrative Contractors on or before September 30, 2017, will be uploaded to the Healthcare Cost Report Information System by December 2017”.  In its announcement, CMS stated that “hospitals have requested CMS provide them with an additional opportunity to revise the Worksheet S-10 submitted with their FY 2014 cost reports (starting on or after October 1, 2013, and prior to October 1, 2014)”.

 

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Topics: Medicare DSH Reimbursement, DSH Reimbursement, Industry Updates, worksheet s-10, S-10, factor 3, CMS transmittal

CMS Issues Transmittal 1863 - FY2015 Worksheet S-10

Posted by Kyle Pennington on Jul 6, 2017 3:58:23 PM

On Friday, June 30, 2017, CMS released Transmittal 1863 (beginning on page 2), which included, among other items, guidance for MACs to follow for accepting cost reports containing revised Worksheet S-10 information. Similar to last year's Transmittal 1681in order for MACs to accept amended cost reports due to revisions to Worksheet S-10 for FY 2015, CMS has put providers on notice by stating that “hospitals must submit their amended cost report containing the revised Worksheet S-10…no later than September 30, 2017.” CMS added, “Submissions received on or after October 1, 2017 will not be accepted.”

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Topics: Medicare DSH Reimbursement, DSH Reimbursement, Industry Updates, worksheet s-10, S-10, factor 3, CMS transmittal

CMS Posts 2018 IPPS Proposed Rule

Posted by Kyle Pennington on Apr 14, 2017 5:48:08 PM

The 2018 IPPS Proposed Rule was put on display for public inspection on April 14, 2017 and is scheduled to be published in the Federal Register on Friday, April 28, 2017.  The pre-publication version can be viewed HERE.  All public comments to the proposed rule are to be received by 5 p.m. EST on Tuesday, June 13, 2017.  SCA will be reviewing and analyzing the details of the proposed rule and its components, and we will provide our conclusions soon. 

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Topics: proposed rule, Medicare DSH Reimbursement, DSH Reimbursement, Industry Updates, S-10

Worksheet S-10 & Transmittal 1681

Posted by Kyle Pennington on Sep 26, 2016 10:18:02 AM

In anticipation that CMS might finalize the DSH/UC payment methodology proposed in the 2017 IPPS proposed rule, CMS released Change Request 9648, Transmittal 1681 (please see page 3, paragraph 2) in July, which included, among other items, guidance for MACs to follow for accepting cost reports containing revised Worksheet S-10 information. Specifically, in order for MACs to accept amended cost reports due to revisions to Worksheet S-10 for FY 2014, CMS put providers on notice by stating that “hospitals must submit their amended cost report containing the revised Worksheet S-10…no later than September 30, 2016.” CMS added, “Submissions received on or after October 1, 2016 will not be accepted.”

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Topics: S-10, DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care

4 Misconceptions Regarding Medicare DSH SSI Recalculations

Posted by Kyle Pennington on Apr 14, 2016 10:00:00 AM

As discussed in a previous blog, a hospital’s Supplemental Security Income (SSI) percentage is a primary component of Medicare Disproportionate Share reimbursement and plays a significant role in determining the reimbursement impact.  Also referred to as the “Medicare” fraction of the Medicare DSH calculation, the SSI ratio represents the percent of patient days for beneficiaries who are eligible for both Medicare Part A and SSI.  By default, SSI ratios are based on the Federal Fiscal year end (10/01 – 09/30) and are generally published annually by the Centers for Medicare and Medicaid Services (CMS).  Current CMS regulations allow for a hospital to request to have its Medicare fraction or SSI ratio recalculated based on the hospital’s cost reporting period where different from the Federal fiscal year, however, a hospital may be hesitant to request due to common misconceptions surrounding SSI recalculations.  Here are four we commonly hear:

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Topics: SSI Recalculations

Another Case for Retroactive Medicaid Eligibility Verification: South Carolina

Posted by Kyle Pennington on Mar 24, 2016 9:38:00 AM

It is not uncommon for patients to retroactively become Medicaid eligible or ineligible a few months (or longer) after a hospital’s cost report filing.  It is also not uncommon to get false positive or negative results due to the tools and methodology used to perform a Medicaid eligibility match.  As most healthcare reimbursement professionals would surely agree, retroactive Medicaid eligibility verification is especially important for its impact on a qualifying hospital’s Medicare Disproportionate Share (DSH) calculation.  When done so properly, retroactive verification of Medicaid eligible patients can confirm compliant results and yield significant increases to the Medicaid fraction of the Medicare DSH calculation.  

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Topics: Medicare DSH Reimbursement

About This Blog

The climate of provider reimbursement is ever-changing and this blog is intended to keep you up-to-date on the latest information regarding:

  • DSH Reimbursement
  • 340B Pharmacy Drug Discount Program
  • Compliance Issues
  • Litigation Surrounding Provider Reimbursement

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