HFS News & Information

On Friday, September 19th^th, 2014, CMS issued Transmittal number 6 to the Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10. Transmittal 6 is effective for cost reporting periods ending on or after June 30, 2014.

The transmittal is available at the CMS website:

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2014-Transmittals-Items/R6P240.html

Major Medicare provisions incorporated by Transmittal 6 include:

• Medicaid managed care discharges will be reported on Worksheet S-3, line 2, column 14.
• Changes were made to Worksheet S-2 and Worksheet D-4 eliminating the “other” organ transplant category from the Worksheets and      check box selections.
• Worksheets S-2, D Part III, D Part IV and E-3 Part V,  were clarified to address new children’s and new cancer hospitals.  A new TEFRA provider will be reimbursed as “Other” in its first year prior to the establishment of a TARGET rate.
• CMS modified the calculation of teaching physician costs on the Worksheet D-5 by adding Parts III and IV.  Parts III and  IV will replace the previous Worksheet D-5, Parts I and II and will apply  the RCE calculations to the teaching physician salaries, similar to the methodology used on Worksheet A-8-2.
• Worksheet E, Part A and the Exhibit 4 instructions were modified to address the extension of the MDH designation and Low Volume Adjustment, through March 31, 2015.
• Line 41.01 was added to Worksheet E, Part A, to report ESRD Medicare covered and paid discharges.  While line 41 (ESRD Medicare Discharges) will be retained and used to compute the 10%      qualifying criteria for the ESDR additional payment, line 41.01 will be used to compute the actual adjustment amount.

HFS is currently programming the software changes for transmittal 6 and anticipates approval in the near future. Once approved, HFS will make the update available to users of the software.

If you have any questions, please contact Eric Swanson at eric@hfssoft.com.

On Friday, August 22^nd , 2014, CMS issued Transmittal number 1 to the Provider Cost Reporting Forms and Instructions, Chapter 43, Form CMS-1984-14. Form CMS-1984-14 is the new Hospice Cost Report for free-standing Hospice providers effective for cost reporting periods beginning on or after October 1, 2014.

The transmittal is available at the CMS website:

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2014-Transmittals-Items/R1P243.html?DLPage=2&DLSort=1&DLSortDir=descending

HFS has completed the programming of the new form set and has submitted a test case to CMS for approval.  We anticipate approval in the near future. Once approved, HFS will make the new form set available to users of the Hospice Form CMS-1984 software.

Major changes from the previous 1984-99 and the new 1984-14 include:

• Date previously reported on the Provider Cost Report Reimbursement Questionnaire, Form CMS-339, has been incorporated into a Worksheet S-2.
• The Worksheet A and B series will now require the separate identification and reporting of patient care service costs by level of care (Continuous Home Care, Routine Home Care, Inpatient Respite Care and General Inpatient)

HFS anticipates scheduling WebEx sessions on the new form sets and software once approved and ready for distribution.  Information regarding the sessions will be distributed to all hospice software users when available.

If you have any questions, please contact Eric Swanson at eric@hfssoft.com.

On Friday, March 28^th, 2014, CMS issued Transmittal number 5 to the Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10.  Transmittal 5 is effective for cost reporting periods overlapping or beginning on or after October 1, 2013.

Major Medicare provisions incorporated by Transmittal 5 include:

• Implementation of Implement of 75% reduction to traditional DSH payments and calculation of Uncompensated Care Payments, in accordance with Section 333 of the Affordable Care Act.
• Incorporation of Model 4 bundled payments for care improvement (BPCI) initiative paid outside of the bundled payment in accordance with ACA 2010, Section 3023.
• Update of the low income patient (LIP) adjustment factor and update of the teaching adjustment factor.
• Inclusion of Medicare labor and delivery days in the calculation of the Medicare patient load ratio used to apportion direct graduate medical education payments in accordance with the Federal Fiscal Year (FFY) 2014 IPPS final rule.

Transmittal 5 also includes two minor clarifications with retroactive application:

• Clarification to instructions for lines 71 and 72, medical supplies charged to patients and implantable devices charged to patients, respectively.
• Addition of  line 39.98 to reflect partial or full credits received from manufacturers for replaced devices

HFS has summited a test case for transmittal 5 to CMS and anticipates approval in the near future.  Once approved, HFS will make the update available to users of the software.

In addition, HFS will be hosting two WebEx sessions on the Transmittal 5 changes.  Both WebEx sessions will be held at 11:00 PST on April 1^st and 3^rd 2014.  Information regarding the sessions will be distributed to all hospital software users.

If you have any questions, please contact Eric Swanson at eric@hfssoft.com.

CMS published the final wage index Public Use File (PUF) reflecting the Final Rule for the FY 2015 IPPS update on July 31, 2014. The July 2014 public use file FY 2015 reflects the final rule wage index data. The effective date of the FY 2015 wage index is October 1, 2014.

The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2015, Final Rule PUF:

FY 2015 final rule Wage Index PUF HFS Modified CSV 2552-10

Sequestration is effective for Services rendered on or after 4/1/2013. It will be prorated for FYE overlapping 4/1/2013 (e.g. a 6/30/2013 FYE has 91 days of Sequestration, so 91/365, times 2%, will be the reduction percentage, or about .50%). Bad Debt changes are effective for FY Begin 10/1/2012 and after, so a 7/1/2012 to 6/30/2013 FY is not affected.

We are awaiting the Hospital (2552-10) Transmittal #4 from CMS, which is to have the Sequestration and Bad Debt Changes (as well as other changes for the ACA). CMS has not released a draft of T-4 as of 7/25/2013. This will be our Version 4.x.x.x.

We received Transmittal #5 for the 2540-10 (SNF), which incorporated the Sequestration and Bad Debt changes. We have submitted a test case and are awaiting CMS approval of our system. This will be our Version 5.x.x.x.

We received Transmittal #2 for the 265-11 (ESRD), which incorporated the Sequestration and Bad Debt changes. We have submitted a test case and are awaiting CMS approval of our system. This will be our Version 2.x.x.x.

We received Transmittal #16 for the 1728-94 (HHA), which incorporated the Sequestration and Bad Debt changes. We have submitted a test case and are awaiting CMS approval of our system. This will be our Version 16.x.x.x.

We received Transmittal #11 for the 222-92 (RHC/FQHC), which incorporated the Sequestration and Bad Debt changes. We have submitted a test case and are awaiting CMS approval of our system. This will be our Version 11.x.x.x.

We received Transmittal #8/9 for the 2088-92 (CMHC), which incorporated the Sequestration and Bad Debt changes. We have submitted a test case and are awaiting CMS approval of our system. This will be our Version 9.x.x.x.

The 216-94, OPO system, is the only approved system “on the street” with the Sequestration changes incorporated (Bad Debt is N/A). This is our Version 5.4.145.0.

CMS released a Draft of the new Hospice, 1984-14 forms and instructions for industry comments 5/29/2013. This is to be effective for FY Begin 1/1/2014 and after. Once comments are addressed and CMS issues the Final, we will know more about what changes are to be made.

CMS published the Preliminary Public Use File (PUF) for the FY 2015 wage index and occupational mix on 9/13/2013. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2011 (FY Beginning from 10/1/10 to 9/30/2011). Hospitals will have until November 21, 2013 to request revisions to the wage data posted in the September PUF.

The following files have been created and can be downloaded and used with the Wage Index Verification Tool for Federal Fiscal Year 2015:

For cost reports filed on the Form 2552-10: 5-3-2014 Hospital WI PUF HFS modified CSV 2552-10

The May 2013 public use files were made available solely for the purpose of identifying any potential errors made by CMS or the fiscal intermediary/MAC in the entry of the final wage index data.

The following files have been created and can be downloaded and used with the Wage Index Verification Tool for Federal Fiscal Year 2015:

For cost reports filed on the Form 2552-96: Hospital FFY 2014 WI PUF HFS modified CSV 2552-96
For cost reports filed on the Form 2552-10: Hospital FFY 2014 WI PUF HFS modified CSV 2552-10

The American Taxpayer Relief Act passed on January 1, 2013 included Medicare provisions that will impact some hospitals for cost reporting periods ending after September 30, 2012.  Section 605 of the Act extends the current Low Volume Payment adjustment through September 30, 2013. The temporary improvements to the Low Volume Payment Adjustment established by ACA Sections 3125 and 10314 were set to expire for services rendered on or after October 1, 2012.  ACA of 2010,

In addition Section 606 of the Act, extended the Medicare Dependent Hospital (MDH) program for services through September 30, 2013.  The MDH program was set to expire for services on or after September 30, 2012.

Both of these provisions will require changes to the 2552-10 cost reporting instructions and we will incorporate these changes into the software when we receive revised instructions from CMS.  If you have any questions, feel free to contact me at eric@hfssoft.com.

We are pleased to announce that Eric Swanson has joined our team at Health Financial Systems.  Many of you know Eric from his previous employment at Blue Cross Blue Shield Association, where he served as the Managing Director for the Strategic Government Initiatives Department.  He has over 30 years of experience in Medicare Part A and was an established expert within the Blue Cross organization, as well as a technical expert to CMS and the provider community.  Eric successfully managed the Blue Cross and Blue Shield Association Medicare operations including PRRB Appeals, Medicare Cost Report development, and Audit and Reimbursement Policy functions.

He is a Graduate of the University of Illinois and earned his MBA from the Lake Forest Graduate School of Management.

Eric has been a featured speaker at HFS user meetings since 1995. He will work out of the Chicago area and contribute in our support department and Government Relations.  Eric will add another dimension of expertise to the HFS team and he looks forward to working with all of our provider and MAC clients.

Eric can be reached by email at Eric@hfssoft.com or by phone (312)265-8386.

CMS approved our new ESRD 265-11 Medicare cost report software on January 30, 2011. We will release the full version of the software on February 3, 2012. You can download the full version of the software from the download page on our website. You can use the new software to prepare and electronically file your cost report(s). Any cost report file(s) you created with the beta version will work with the new full version of the 265-11 software.

Please note the new file extension for the 265-11 cost report data files is .mcrx. You will be able to open both 265-94 and 264-11 cost report using the yellow icon HFS software. Both the 265-11 and 265-94 systems are installed in the same folder and both start with the same yellow HFS icon-shortcut.

The use template option is not yet operational. We will get the template feature up and running as soon as possible, but currently you will only be able to open a blank, new 265-11 cost report.

Effective Dates (January 1, 2011 and after)
Form CMS-265-11 must be completed by all independent end stage renal dialysis (ESRD) facilities that are not hospital-based for cost reporting periods ending on or after January 1, 2011.

Extended Filing Deadlines for 265-11 Cost Reports
CMS recently extended the filing deadline for ESRD 265-11 cost reports. The following table contains the new cost report due dates.