Southwest Consulting Associates Blog

FY 2020 Inpatient Rehab Proposed Rule Update

Posted by Stacie Snider on Apr 22, 2019 3:57:59 PM

The Inpatient Rehab FY 2020 Proposed Rule was put on display for public inspection on April 17, 2019. The proposed rule is scheduled to be published in the Federal Register on April 24, 2019, however, the pre-publication version can be viewed here. This IRF rule will affect discharges on or after October 1, 2019.

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Topics: proposed rule, provider reimbursement, inpatient rehab

FFY 2017 MAC Letters & Aberrant Worksheet S-10 Data

Posted by Jeff Norman on Apr 10, 2019 11:20:14 AM

On April 8, 2019, SCA was provided multiple copies of a MAC letter informing hospitals of potentially aberrant data reported on Worksheet S-10 for federal FY 2017.  While we have only seen a few letters to date, it is our understanding that this is a CMS initiative affecting many hospitals. Here is what we have been told at this point:

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Topics: uncompensated care, S-10, worksheet s-10, factor 3, uncompensated care payment, cost to charge ratio, Medicare Cost Report, S-10 audit, provider reimbursement

FFY 2017 SSI Ratios Posted to CMS Website for Medicare DSH

Posted by Jamie Pennington on Apr 4, 2019 4:57:30 PM

CMS posted the FFY 2017 SSI ratios to their website.  The FFY 2017 SSI ratio file (DSH Adjustment and 2016-2017 File [ZIP, 246KB]) can be found in the Downloads section of CMS' Disproportionate Share Hospital (DSH) webpage or by following the link below:

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, SSI Recalculations, factor 3, ssi ratio, uncompensated care payment

PODCAST: Worksheet S-10 Scope, Uses and Implications

Posted by Jamie Pennington on Mar 12, 2019 11:46:52 AM


Southwest Consulting Associates recently participated in a segment of the THA SOLUTIONS Podcast where SCA President Michael Newell discussed the Medicare cost report Worksheet S-10 with Texas Hospital Association's Lance Lunsford. The sixteen minute conversation was part of the podcast segment titled, "Maintain Compliance to Maximize Hospital Funding" and can be heard in its entirety by selecting the play button located at the end of this post.

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Topics: uncompensated care, S-10, worksheet s-10, uncompensated care payment, Medicare Cost Report, S-10 audit, provider reimbursement

PRRB Rules and Electronic System

Posted by Stacie Snider on Feb 28, 2019 10:28:03 AM

In January, CMS issued a MLN Matters newsletter reviewing the new electronic system for Provider Reimbursement Review Board (PRRB) Medicare cost report appeals. The electronic system, referred to as OH CDMS (Office of Hearings Case and Document Management System), is a web-based portal that allows providers to submit all necessary appeals documents electronically.

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Topics: PRRB, appeals, Medicare Cost Report, provider reimbursement, PRRB rules

Observations from MAC Audits - Worksheet S-10

Posted by Michael Newell on Feb 25, 2019 3:22:49 PM

Hospitals nationwide have been undergoing Worksheet S-10 “reviews” for FY 2015 that in large part culminated at the end of January 2019. Since then, there has been word that additional technical direction was provided to MACs by CMS (not yet shared with hospitals) that addresses how to apply some “findings” from those reviews. Even though the current audit process has not been fully completed, there is much to learn about what has transpired so far and how that may impact future reviews or even future changes to cost reporting instructions.

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Topics: S-10, worksheet s-10, S-10 audit

FFY 2019 Medicare Cost Report Submission Reminders

Posted by Jamie Pennington on Feb 15, 2019 1:10:47 PM

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.  

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Topics: Medicare DSH Reimbursement, Industry Updates, S-10, final rule, worksheet s-10, cost reporting, Medicare Cost Report

FY 2019 IPPS Rule, Worksheet S-10 Audits & Going Forward

Posted by Jamie Pennington on Feb 11, 2019 12:55:30 PM

Southwest Consulting Associates was featured in the latest issue of the Dallas-Fort Worth Hospital Council's Interlocutor magazine.  Beginning on page 24, Kyle Pennington reviews the FY 2019 IPPS rule, the inaugural audits of Medicare cost report Worksheet S-10 data and what's coming up next for hospital providers and their reimbursement teams. 

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Topics: S-10, final rule, worksheet s-10, Medicare Cost Report, S-10 audit, ipps rule

FY 2020 Wage Index Deadline Reminders

Posted by Michael Newell on Feb 6, 2019 9:49:07 AM

Yesterday, CMS held an Open Door Call to discuss two agenda items, one of which was the posting of the FY 2020 hospital area wage index data and occupational mix public use file. As you know, according to the FY 2020 Hospital Wage Index Development Timetable, hospitals have until February 15, 2019 to submit correction requests regarding their data.

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Topics: wage index, CMS Public Use File

Worksheet S-10 Audits

Posted by Kyle Pennington on Feb 4, 2019 12:33:57 PM


The Uncompensated Care pool reimbursement payment is viewed as a zero-sum game, with one hospital’s reimbursement gain through the program becoming another hospital’s loss.  While Worksheet S-10 has been used for UC reimbursement purposes for only a short time, audits of the S-10 data to ensure its accuracy and consistency have been a high priority for hospital providers.  In its 2019 final IPPS rule, CMS stated that, due to the overwhelming feedback from commenters emphasizing the importance of audits, they would begin the inaugural audits in fall 2018. 

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Topics: uncompensated care, S-10, worksheet s-10, Medicare Cost Report

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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