Transmittal 21 is effective for FYE on or after 10/1/2009 (i.e. must use T.21 for FYE 10/1/2009 and after), except for the H1N1 Vaccine changes which are effective for services on or after 9/1/2009.
T.21 added three new ancillary cost centers, Cardiac Rehab, Hyperbaric Oxygen Therapy, and Lithotripsy. These will be available from our “pick list” of cost centers. W/S S-3 part I, line 26, columns 5.01, 5.02, 6.01, and 6.02, for Observation Bed Days, are N/A for FY Begin 10/1/2009 and after. No more “admitted” and not admitted split.
Total observation bed days will now be subtracted in the calculation of E part A, line 3 (bed days available). W/S E part A and L part I, line 4.01 or 5.01, are revised to INCLUDE in Total days, the Labor and Delivery Days from the NEW line 29 of S-3 part I. This is effective for FY Begin 10/1/2009 and after.
W/S S-2 line 21.01, column 2 was added for Pickle providers (“Y” indicates Pickle for operating DSH). If Pickle, then the allowable DSH percentage is automatically 35%, on E part A line 4.03.
W/S E-3 part I, lines 1.02, 1.04, 1.41, and 1.42 must be subscripted for column 1.01, if the FY overlaps 10/1/2009, as the LIP “factor” changed from 0.6229 to 0.4613. You only need to split payments on line 1.02 as we calculate the rest. W/S M-3 line 14 calculation is phasing out the “limit”, over 5 years. For services through 12/31/2009 the 62.5% limitation remains. For services 1/1/2010 to 12/31/2011, the limit is 68.75%. For services 1/1/2012 to 12/31/2012 the limit is 75%. For services 1/1/2013 to 12/31/2013 the limit is 81.25%. For services on or after 1/1/2014, the limit is zero, or 100% reimbursement.
W/S M-4 added columns 2.01 and 2.02 for the H1N1 vaccine. Medical Supply cost, Total injections, and Medicare injections must be split between Pneumococcal, Influenza, H1N1 Only, and Influenza and H1N1 combined.
For even more up-to-date news, visit Pete Harmon’s blog at http://www.hfssoft.com/blogs/pete/