Last Fall, CMS made updates to the cost reporting software and the rules for filing a hospital Medicare cost report. Additionally, there were new and noteworthy changes included in the FY 2019 IPPS Final Rule. Specifically, the FY 2019 Final IPPS rule included new requirements for cost reports submissions with periods beginning on or after 10/1/2018. Providers must now submit both Worksheet S-10 and Medicare DSH patient level detail along with their cost report submissions.
For charity care detail, CMS provided examples of the information needed to support Worksheet S-10 data such as patient name, dates of service, insurer, and the amount of charity care or uninsured discounts given that corresponds to the amount claimed in the hospital’s cost report. If your hospital has historically used summary reports to report S-10 values, those will no longer suffice under this new requirement. Additionally, summary reports have the potential to vary greatly from the actual detail of charity and bad debt write-offs that occurred during the fiscal year. Hospitals that do not supply patient level detailed information will have their cost reports rejected for lack of supporting documentation.
Additionally, the FY 2019 IPPS Final Rule states that for the same cost reporting periods beginning on or after October 1, 2018, each DSH-qualifying hospital must now include, as part of the cost report filing, a detailed listing of its Medicaid eligible days that corresponds to the Medicaid eligible days claimed in the cost report as supporting documentation. This requirement affects the acceptability of the cost report. Without a detailed listing, a cost report will be deemed unacceptable and thus, your report will be rejected. Going forward, if a hospital submits an amended cost report, whether that be the “12-month” cost report, or another amended cost report, an amended listing or an addendum to the original listing would need to be submitted as supporting documentation with any amended cost report.
As mentioned in the beginning of this post, CMS made cost reporting software updates last Fall. You can find our post about those updates here. If you need assistance compiling your patient detail documentation for Medicare DSH or Worksheet S-10 that supports the data on your cost report or would like your cost report reviewed prior to submission as part of our suite of cost reporting services, please let us know. Good luck with your Medicare cost report filings!
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