The Independent Rural Health Clinic (RHC)/Freestanding Federally Qualified Health Centers (FQHC) Cost Report, Form CMS-222-92 was updated to Transmittal 13 by CMS, on February 17, 2017. Transmittal 13 is effective for cost reporting periods ending on or after September 30, 2016.
Effective for cost reporting periods beginning on or after October 1, 2014 the Form CMS-222-92 cost report is only applicable to RHC providers. FQHC providers are currently required to file the Form CMS-224-14 cost report.
Changes include:
- On Worksheet A, expanded the instructions for Allowable and Non-Allowable GME Pass through Costs on lines 20.50 and 53.50, respectively.
- Also on Worksheet A, added the following cost centers:
- Line 55.50 for Chronic Care Management (CCM)
- Line 55.60 for Telehealth
- Worksheet A-2, line 8.01 was added to accommodate the application of the RCE adjustment for teaching physicians.
- Worksheet B, Part II, line 14.01 was revised to eliminate the separate calculation of overhead for direct graduate medical education (GME).
- Revised Worksheet C, Part II, line 15.10 for direct GME costs.
- Also on Worksheet C, Part II, added line 20.99 to capture the Pioneer Accountable Care Organization (ACO) demonstration payment adjustment amount in accordance with ACA 2010, §3022.
HFS is currently programming the software changes for transmittal 13 and anticipates approval in the near future. Once approved, HFS will make the update available to users of the software.
The transmittal is available at the CMS website:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017-Transmittals-Items/R13P299.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending
If you have any questions please contact eric@hfssoft.com.
The HHA, 1728-94 was updated to Transmittal 17 by CMS, on October 7, 2016. Transmittal 17 is effective for cost reporting periods beginning on or after October 1, 2015. HFS was approved for Transmittal 17 on January 30, 2017 and anticipates the release of updated software February 10, 2017. HFS will be hosting a WebEx on the 1728-94 Changes, System release and other updates on March 1, 2017.
Transmittal 17 was primarily to implement the statutory requirement for hospice payment reform in §3132 of the Patient Protection and Affordable Care Act (ACA) and to incorporate data previously reported on the Provider Cost Report Reimbursement Questionnaire, Form CMS-339.
Changes include:
- Addition of Worksheet S-2-1, to include questions previously required in Form CMS-339
- Removed obsolete Worksheets S-6 and J-1 through J-4.
- Removed obsolete Worksheets RH-1 through RH-2.
- Removed obsolete Worksheets FQ-1 through FQ-2.
- Addition of Worksheets S-5 Parts III & IV and Worksheets O through O-8 for any HHA based hospice with a cost reporting period beginning on or after October 1, 2015 AND ENDING on or after September 30, 2016.
- Effective for cost reporting periods beginning on or after October 1, 2014, HHA-based FQHCs will be required to complete a separate Form CMS-224-14.
This release updates the HFS 1728-94 to the HFS .mcrx file format and updated platform. This is backwards compatible. Users will receive notification when opening their existing .mcr files that the files will be converted to the new platform. No data will be lost and the user functionality will be the same. Of course, if you have any problems please contact us right away.
The transmittal is available at the CMS website:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2016-Transmittals-Items/R17p232.html?DLPage=2&DLEntries=10&DLFilter=R17&DLSort=1&DLSortDir=ascending
The Hospital, 2552-10 was updated to Transmittal 10 by CMS, on November 17, 2016. Transmittal 10 is effective for cost reporting periods beginning on or after October 1, 2015. HFS will be hosting a WebEx on the 2552-10 Changes, System release and other updates on February 9, 2017.
Transmittal 10 changes include:
- Worksheet S-2, Part I
- Added line 171, column 2, to capture section 1876 Medicare days.
- Worksheet S-3, Part II
- Added lines 14.01, 14.02, 25.50, 25.52 and 25.53, to enhance the wage index data collection effective for cost reporting periods beginning on or after October 1, 2015.
- Worksheet S-3, Part IV
- Eliminated the Wage Index Pension Cost Schedule (Exhibit 3) and the corresponding instructions and directed providers to use the latest published Wage Index Pension cost Schedule on the CMS website.
- Added lines 8.01, 8.02, and 8.03, to accommodate various categories of health insurance effective for cost reporting periods beginning on or after October 1, 2015.
- Worksheet S-5
- Added line 23 to capture low volume treatments by CNN.
- Worksheet S-9, Parts I-IV
- Effective for cost reporting periods beginning on or after October 1, 2015 AND ENDING on or after September 30, 2016, hospital-based hospices will no longer complete Parts I and II, but will complete the new Parts III and IV.
- Worksheet S-10
- Clarified instructions for line 20 for the total initial payment obligation of patients approved for charity care.
- Changed the references to State Children’s Health Insurance Program (SCHIP) to Children’s Health Insurance Program (CHIP) in the instructions and on the worksheet.
- Worksheet S-11
- This new worksheet captures statistics related to hospital-based FQHCs paid under the FQHC prospective payment system (PPS) that meet the requirements set forth in 42 CFR 413.65(n). These worksheets supersede Worksheet S-8 for FQHCs only and are effective for cost reporting periods beginning on or after October 1, 2014.
- Worksheet E, Part A
- Clarified and expanded instructions for partial year MDH.
- Modified instructions for line 54 to include in the add-on payment for new technologies payments associated with Model 4 Bundled Payments for Care Improvement initiative.
- Added line 54.01 to accommodate the islet isolation transplantation add-on payment effective for services rendered on or after October 1, 2016, in accordance with CR 9570.
- Worksheet E-3, Part IV
- Added lines 1.01 through 1.04 to accommodate new payment categories for Long-Term Care Hospitals in accordance with the 2016 Inpatient Prospective Payment System final rule effective for discharges in cost reporting periods beginning on or after October 1, 2015.
- Worksheet E-4
- Added lines 10.01, 15.01, and 16.01, to accommodate unweighted resident FTE counts. These amounts are used to reconcile with amounts in the Intern and Resident Information system (IRIS) and do not impact the settlement summary.
- Revised instructions for lines 42 and 43 to reflect Part B reasonable costs and the primary payer amounts, for provider-based FQHCs completing the Worksheet N series.
- Worksheet I-1
- Modified instructions for line 10 through 16, revising the effective date for line 15 (Drugs) to cost reporting periods beginning on or after October 1, 2015, to capture Erythropoiesis stimulating agents (ESA).
- Modified instructions for line 27 (Subtotal) to reflect the applicable reconciliation to Worksheet B, Part I, for cost reporting periods beginning prior to October 1, 2015 and on or after October 1, 2015.
- Worksheets I-2 and I-3
- Clarified instructions for lines 14 and 15 to include all ESA costs on line 14 for cost reporting periods beginning on or after October 1, 2015.
- Worksheet M series
- Modified instructions to convey that the Worksheet M series no longer applies to hospital-based FQHCs, effective for cost reporting periods beginning on or after October 1, 2014. However, hospital-based rural health clinics still complete the “M” worksheet series.
- Worksheet M-1: Added new cost centers for telehealth and chronic care management.
- Revised forms and instructions to comply with the regulations at 42 CFR 413.78(a), to ensure that no separate graduate medical education (GME payment is calculated for the hospital-based RHC or FQHC.
- Worksheet N series
- Effective for cost reporting periods beginning on or after October 1, 2014, hospital-based FQHCs complete the new Worksheet N series and are reimbursed under the FQHC prospective payment system.
- Worksheet K series
- Modified instructions to reflect that the Worksheet K series no longer applies to hospital-based hospices effective for cost reporting periods beginning on or after October 1, 2015 AND ENDING on or after September 30, 2016.
- Worksheet O series
- Effective for cost reporting periods beginning on or after October 1, 2015 AND ENDING on or after September 30, 2016, hospital-based hospices complete the new Worksheet O series.
HFS was approved for the Transmittal 10 changes on January 30, 2017 and the software will be distributed February 3, 2017 to hospital software clients.
The full Transmittal is available at the CMS website:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2016-Transmittals-Items/R10P240.html?DLPage=1&DLEntries=10&DLFilter=R10&DLSort=1&DLSortDir=ascending.
If you have any questions, please contact Eric Swanson at eric@hfssoft.com.
On Friday, July 15th, 2016, CMS issued Transmittal number 1681 to Publication 100-20.
Major Medicare provisions incorporated by this Transmittal include:
- Instructions notifying Medicare Administrative Contractors (MACs) of the availability of updated data and instructions on how to access such data for determining the disproportionate share adjustment for IPPS hospitals and the low income patient (LIP) adjustment for IRFs as well as payments as applicable for LTCH discharges for Federal Fiscal Year 2014 Cost Reports.
- Instructions that also provide guidance for accepting FY 2014 amended cost reports from hospitals requesting to revise Worksheet S-10 (i.e., cost reports starting on or after October 1, 2013 and prior to October 1, 2014) in light of CMS’s proposal to begin using Worksheet S-10 data to determine uncompensated care payments starting in FY 2018. This Transmittal will require providers to submit any S-10 amended data by September 30, 2016.
The full Transmittal is available at https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1681OTN.pdf
If you have any questions, feel free to contact Eric Swanson at eric@hfssoft.com.
CMS published the Preliminary Public Use File (PUF) for the FY 2017 wage index and occupational mix on 5/16/2016. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2014 (FY Beginning from 10/1/13 to 9/30/2014). Hospitals will have until September 2, 2016 to request revisions to the wage data posted in the May PUF.
The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2018, Preliminary PUF:
FY 2018 May 16 2016 Wage Index PUF HFS Modified CSV 2552-10
The Hospital, 2552-10 was updated to Transmittal 9 by CMS, on March 18, 2016. Transmittal 9 is effective for cost reporting periods beginning on or after October 1, 2015.
Significant Transmittal 9 changes include:
- Addition of Worksheet S-2, Part I, line 37.01 and instructional changes to Worksheet E, Part A, to implement special payment provisions for Medicare-Dependent, Small Rural Hospitals (MDH) eligible for transitional hospital-specific payments. The November 13, 2015, Outpatient PPS Final Rule identified 8 MDH hospitals that were re-designated as Urban based on the adoption, of the new OMB delineations, however did not qualify to apply for rural status. These hospitals will qualify for a transitional HSP payment as follows:
o Discharges 1/1/2016 – 9/30/2016 – Federal rate plus two-thirds of 75% of the amount by which the Federal rate payments is exceeded by the HSR
o Discharges 10/1/2016 – 9/30/2017 – Federal rate plus one-third of 75% of the amount by which the Federal rate payments is exceeded by the HSR
- Worksheet S-2, Part I, line 122 was added to identify cost reports that contain “state health or similar taxes” and the location of those taxes on Worksheet A.
HFS is reviewing the changes and will submit a revised system for approval when a CMS test case is available. Transmittal 9 will not be required for full cost reporting periods ending 12/31/2015.
The full Transmittal is available at the CMS website:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2016-Transmittals-Items/R9P240.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending
If you have any questions, please contact Eric Swanson at eric@hfssoft.com.
We are excited to announce this year’s HFS Hospital Provider User Meeting will be in Denver, Colorado on October 13th and 14th. There will be a total of 16 CPE credits offered and registration will be $600 per person.
This meeting will be held at the Sheraton Denver Downtown Hotel. If you book your hotel room before September 9, 2016 and let them know you are with the Health Financial Systems group, you will receive the special room rate of $189 (plus tax).
Click here to book a room at the Sheraton Denver Downtown Hotel or call (303)893-3333. The room rate is good until September 9, 2016.
We look forward to seeing you in Denver, Colorado in October!
CLICK HERE TO REGISTER
Click here for a look at the proposed Agenda.
NEW: Download Presentations Online Before the Event
To conserve resources and protect the environment, HFS will no longer provide printed materials at our events free of charge. The materials will be available online for download before the event and may be viewed on your laptop/tablet. A link for downloading will be provided to attendees prior to the meeting. Hard copies can be ordered at time of registration but there will be an additional charge.
Please register for the meeting as soon as possible as we do have limited space. Contact us at support@hfssoft.com if you have any questions or comments regarding the upcoming HFS Hospital Provider User Meeting.
HFS has developed Beta software incorporating the draft forms and anticipates that CMS will release final forms and instructions in the spring of 2016. While no extension date has been established, MACs have been instructed not to request impacted cost reports until further notice.
HFS is working to make this a smooth transition. We currently have a beta system available for download at our website or through check for updates for clients that identified themselves as FQHC in the survey distributed 1/27/2016. Once CMS finalizes the forms we will submit for, hopefully, a quick approval and get you an approved system as soon as possible.
Please note that you can use the beta system to start 224-14 cost reports and that any data entered into the beta system will be retained when the system is updated for the approved version.
The HFS Beta System was developed based on the Draft forms published on the CMS website:
https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-224-14.html?DLPage=1&DLEntries=10&DLFilter=cost%20report&DLSort=1&DLSortDir=descending
The new draft form is CMS-224-14 and will be effective for cost reporting periods beginning on or after October 1, 2014. This effective date reflects the implementation date of the new FQHC PPS, required under the Affordable Care Act.
If you have any questions, please contact Eric Swanson at eric@hfssoft.com.
On September 4, 2015, CMS issued a Federal Register notice releasing a draft of revisions to the HHA Cost Report. The new draft form revisions are being proposed to accommodate the statutory requirement for hospice payment reform and the statutory requirement establishing a prospective payment system for Federally Qualified Health Centers in the ACA.
This draft was recently made available at the CMS website:
https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-1728-94.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending
Major proposed changes include:
- CMS is proposing that effective for cost reporting periods beginning on or after October 1, 2014, HHA-based FQHCs would be required to complete the proposed free-standing Form CMS-224-14.
- CMS is proposing to add a Worksheet S-2-1, to replace the current requirement to file a separate Form CMS-339.
- CMS is proposing to eliminate the J Series, previously used for the reporting of Home Health based CORF services.
- CMS is proposing to add Worksheet S-5, Parts III and IV, to implement the new reporting for Hospice services effective for cost reporting periods beginning on or after October 1, 2015.
- CMS is proposing to add an O Series of Worksheets, to implement the new reporting for Hospice services effective for cost reporting periods beginning on or after October 1, 2015.
If you wish to comment on this draft, you may do so until November 3, 2015 at the following website:
http://www.regulations.gov/#!documentDetail;D=CMS_FRDOC_0001-1767