CMS published a Public Use File (PUF) for the FY 2025 wage Index January 31, 2024. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2021 (FY Beginning from 10/1/2020 to 9/30/2021).
The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2025, PUF. Note, February 16, 2024 is the deadline for hospitals to submit requests (including supporting documentation) for: 1) corrections to errors in the January PUFs due to CMS or MAC mishandling of the wage index data, or 2) revisions of desk review adjustments to their wage index data as included in the January PUFs (and to provide documentation to support the request). MACs must receive the requests and supporting documentation by this date.
https://www.hfssoft.com/doc/FY25_Jan_PUF.20240131.S-3 Data PUF.csv
In accordance with the Paperwork Reduction Act (PRA) of 1995, the Centers for Medicare & Medicaid Services (CMS) published a notice in the Federal Register dated September 27, 2023 regarding a proposed revision to the Skilled Nursing Facility and Skilled Nursing Facility Healthcare Complex Cost Report (proposed Form CMS-2540-23). Links to the Federal Register notice and PRA posting are below and comments must be received by November 27, 2023. Instructions for providing comments are included in the Federal Register notice and a summary of the proposed changes is contained in the Supporting Statement contained within the PRA notice.
Federal Register Notice
Published PRA Notice
CMS published a preliminary Public Use File (PUF) for the FY 2025 wage Index May 23, 2022. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2021 (FY beginning from 10/1/20 to 9/30/2021).
The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2025, Preliminary PUF:
https://www.hfssoft.com/doc/FY25_May_S3_Preliminary_PUF.20230710.S-3 Data PUF.csv
CMS has released the final FY 2024 wage index and occupational mix data PUFs on CMS Web page. Hospitals will have approximately 1 month to verify their data and submit correction requests to both CMS and their MAC to correct errors due to CMS or MAC mishandling of the final wage and occupational mix data. A hospital requesting a correction must submit its request, by email (email only will be permissible), along with complete, appropriate detailed documentation, to both its A/B MACS and CMS, no later than May 26, 2023. The PUF is available at the below link:
https://www.hfssoft.com/doc/FY24_April_PUF.20230428.S-3 Data PUF.csv
CMS published a Public Use File (PUF) for the FY 2024 wage Index January 30, 2023. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2020 (FY Beginning from 10/1/2019 to 9/30/2020).
The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2024, PUF. Note, February 15, 2023 is the deadline for hospitals to submit requests (including supporting documentation) for: 1) corrections to errors in the January PUFs due to CMS or MAC mishandling of the wage index data, or 2) revisions of desk review adjustments to their wage index data as included in the January PUFs (and to provide documentation to support the request). MACs must receive the requests and supporting documentation by this date.
https://www.hfssoft.com/doc/FY24_Jan_PUF.20230130.S-3 Data PUF.csv
CMS issued Transmittal 18 to the 2552-10 on December 29th, 2022. Transmittal 18 has been issued with an effective date of Cost Reporting Periods Beginning on or After October 1, 2022 and implements many of the changes proposed through the PRA process including:
- Addition of Exhibits for reporting:
- Medicare bad debt by beneficiary,
- Medicaid Eligible Day for DSH Eligible Hospitals,
- Charity care charges by patient.
- Total bad debts by patient.
- Identification of permanent adjustments to the TEFRA target amount per discharge.
- Identification of providers purchasing greater than fifty percent of its professional services from an unrelated organization located outside the main hospital’s local area labor market.
- Identification of the number of temporary expansion COVID-19 public health emergency acute care beds.
- Revisions to Worksheet S-10.
- Addition of Worksheet D-6 Parts I through IV to compute allogeneic HSCT acquisition costs as required under §1886(d)(5)(M) of the Social Security Act and in accordance with the statutory requirement under Section 108 of the Further Consolidated Appropriations Act, 2020 (Pub. L. 116-94) for reasonable cost payment.
- Addition of Worksheet E-5 for the contractor to report the outlier reconciliation amount during cost report tentative settlement.
This Transmittal also implements FY 2023 IPPS final rule changes including DGME changes in regards to the Hershey litigation effective for cost reporting periods beginning on or after October 1, 2022. With revisions to Worksheet E-4 and the addition of Worksheet S-2, Part I, Line 68 to identify cost reports for periods beginning prior to October 1, 2022, that are eligible for the modified method of calculating direct GME payments to a teaching hospital when the hospital’s weighted FTE counts exceed their direct GME FTE cap in accordance with the FY 2023 IPPS final rule
Other Worksheet E-4 changes have been made to implement Sections 126, 127 and 131 of the CAA 2021.
This Transmittal also implements changes relating to the Community Health Access and Rural Transformation (CHART) model. The CHART model is effective for discharges ending on or after January 1, 2024, for inpatient services, outpatient services, and CAH swing-bed services.
Other changes include the extension of the low volume adjustment and the Medicare Dependent Hospital (MDH) program, but these changes are subject to subsequent Law provisions.
HFS is evaluating all finalized changes and will be working with CMS to implement and receive approval of the changes within the software.
CMS Published Transmittal 18 at the below link to the CMS website:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Transmittals/r18p240i
The Home Office Cost Statement, Form CMS-287-22 Transmittal 1 was published by CMS, on October 28, 2022. Transmittal 1 is effective for cost reporting periods beginning on or after October 1, 2022.
This Transmittal implements an electronic reporting requirement for the home office cost statement and updates the forms to more closely reflect other Medicare form sets. Major changes include:
- Designated Schedule S, Part I as Cost Statement Status and added data elements identifying the status, and added the electronic signature statement to the S, Part II Certification.
- Designated Schedule S-1, Part I as Home Office Data to capture identification information applicable to the home office/chain organization (HO/CO); designated key officer data as Part II. This data was previously reported on Schedule A, Part I.
- Designated Schedule S-2, Parts I, II, and III as Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively, to list the components of the HO/CO. This data was previously reported on Schedule A, Parts III-V.
- Designated Schedule A as the updated Reclassification and Adjustment of Trial Balance of Expenses. This data was previously reported on Schedule B.
- Designated Schedule A-6 as the updated Reclassifications of Expenses. This data was previously reported on Schedule B-1.
- Designated Schedule A-7, Part I as Analysis of Changes in Capital Asset Balances; designated Part II as Reconciliation of Capital Cost Centers. This data was previously reported on Schedule B-2.
- Designated Schedule A-8 as the updated Adjustments to Expenses. This data was previously reported on Schedule C.
- Designated Schedule A-8-1 Part I as Adjustments Required as a Result of Transactions with Related Organizations and/or Home Office/Chain Organizations; Designated Part II as Interrelationship of Home Office/Chain Organization to Related Organizations. This data was previously reported on Schedule D.
- Designated Schedule B, Parts I, II, & III as Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively, for direct allocations of capital related costs. This data was previously reported on Schedule E.
- Designated Schedule B-1, Parts I, II, & III as Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively, for direct allocations of non-capital related costs. This data was previously reported on Schedule E-1.
- Designated Schedule C, Parts I, II, & III as Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively, for function allocations of capital related costs. This data was previously reported on Schedule F, Part I.
- Designated Schedule C-1, Parts I, II, & III as Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively, for statistics to functionally allocate capital related costs. This data was previously reported on Schedule F, Part II.
- Designated Schedule D, Parts I, II, & III as Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively, for function allocations of non-capital related costs. This data was previously reported on Schedule F-1, Part I.
- Designated Schedule D-1, Parts I, II, & III as Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively, for statistics to functionally allocate non-capital related costs. This data was previously reported on Schedule F-1, Part II.
- Designated Schedule E for the allocation of pooled costs for the double allocation method. This data was previously reported on Schedule G, Part I.
- Designated Schedule E-1, Parts I, II, & III for the allocation of pooled costs to Healthcare Components, Non-Healthcare Components, and Region/Division Components, respectively. This data was previously reported on Schedule G, Part II.
- Added the Schedule F, Parts I, II, and III, to summarize capital related costs by healthcare components, non-healthcare components, and region/division components, respectively.
- Added the Schedule F-1, Parts I, II, and III, to summarize non-capital related costs by healthcare components, non-healthcare components, and region/division components, respectively.
- Designated Schedule G as the updated Balance Sheet. This data was previously reported on Schedule J.
- Designated Schedule G-1 as the updated Statement of Revenues and Expenses. This data was previously reported on Schedule I.
CMS has started the test/approval process and HFS expects T1 software to be approved and available for use soon. The published T-1 transmittal can be found at the link below:
https://www.hfssoft.com/doc/R1P248.zip
In accordance with the Paperwork Reduction Act (PRA) of 1995, the Centers for Medicare & Medicaid Services (CMS) published a notice in the Federal Register dated June 22, 2022 regarding a proposed revision to the Hospital and Health Care Complex Cost Report (proposed Form CMS-2552-10). Links to the Federal Register notice and PRA posting are below and comments must be received by July 22, 2022. Instructions for providing comments are included in the Federal Register notice and a summary of the proposed changes is contained in the Supporting Statement contained within the PRA notice.
Federal Register Notice
Published PRA Notice
CMS published a preliminary Public Use File (PUF) for the FY 2024 wage Index May 23, 2022. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2020 (FY Beginning from 10/1/19 to 9/30/2020).
The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2024, Preliminary PUF:
FY_2024_Prelim_S3 wage tab_20220523.csv