HFS News & Information

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

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

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

CMS released a revised final FY 2022 wage index and occupational mix data PUFs on the CMS Web page, August 3, 2021. This file reflects provider correction requests due to CMS or MAC mishandling of the final wage and occupational mix data.

The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the final Federal Fiscal Year 2018 wage index data.

FY_2022_Final_S3_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 November 10, 2020  regarding a proposed revision to the Hospital and Health Care Complex Cost Report (proposed Form CMS-2552-10 Transmittal 17).   Links to the Federal Register notice and PRA posting are below and comments must be received by January 11, 2021.  Instructions for providing comments are included in the Federal Register notice and significant proposed changes include:

• Update to Certification page to better incorporate the electronic signature into the official form.
• Added Worksheet S-12 to collect “Median Payer-Specific Negotiated Charge Data” effective for cost reporting periods ending on or after January 1, 2021
• Added Worksheet D-6 to reimburse for Allogeneic Hematopoietic Stem Cell and CAR T-Cell Therapy effective for cost reporting periods beginning on or after October 1, 2020.
• Added Worksheet E-5 for Outlier Reconciliation at Tentative Settlement for cost reporting periods beginning on or after October 1, 2020.
• Added Exhibit 2A – Replaces Exhibit 2 as of FYB 10/1/2020 with 25 columns and instructions for the information required to support the bad debt claimed in the cost report.
• Added Exhibit 3A – Providing a standard format for the listing of Medicaid Eligible Days for DSH Eligible Hospitals required to support the DSH eligible days reported that must be submitted with cost reports for periods beginning on or after October 1, 2020.
• Added an Exhibit 3B providing a standard format for the information required to support the charity care amounts claimed that must be submitted with cost reports for periods beginning on or after October 1, 2020.
• Added an Exhibit 3C providing a standard format for the information required to support the total bad debt expense claimed.

Federal Register Notice

Published PRA Form

On August 21, 2020 CMS posted two significant change requests to its website.

CR 11644 – Communicated changes to the cost report acceptability checklists used by MACs to make acceptable cost report determinations.  This CR removes the review of the PI file encryption codes and establishes Provider documentation variance allowance of +-3 percent.  The full Change Request is available at: https://www.cms.gov/files/document/r10316otn.pdf.

In addition, CMS issued CR 11642.  This CR provides MAC instructions regarding the calculation of nursing and allied health Medicare+Choice payments and the proportional reduction to MA direct GME payments.  The changes to the proportional reduction to MA direct GME payments were initiated in Transmittal 16 of Form CMS 2552-10.  The full Change Request is available at: https://www.cms.gov/files/document/r10315otn.pdf.

CMS has directed MACs to further extend the cost reporting deadlines for the following cost reporting fiscal year ends for all provider types:

* Please note these are new extensions.

While we have been told that CMS is considering the 3-31-2020 FYE providers that are currently due 8-31-2020, no extension has been posted at this time.

Please contact HFS Support support@hfssoft.com, for any comments or questions.

CMS published new documentation requirements for filing Medicare Cost Report in the Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) Final Rule.  These new requirements are effective for cost reporting periods beginning on or after October 1, 2018 and additional information can be found in SE 19015 . While CMS initially addressed standardized formats for the submission of the new documentation the following was communicated in the SE 19015.

“As noted in the Final Rule, the Centers for Medicare & Medicaid Services (CMS) agrees that requiring this information to be submitted in standardized formats would ensure consistency of the documentation and facilitate the contractor’s review. CMS plans to include standard formats (templates) in a Paperwork Reduction Act notice to request public comment. Therefore, standardized formats will not be required for cost-report periods beginning on or after October 1, 2018, until further notice. [emphasis added]”

HFS will continue to monitor the implementation of the new documentation requirements and will notify clients of any additional information.