CMS has granted an extension from September 30, 2017 until October 31, 2017 for ALL Inpatient Prospective Payment System (IPPS) hospitals to resubmit certain Worksheet S-10 data. For revisions to be considered, amended FY 2014 and FY 2015 cost reports due to revised or initial submissions of Worksheet S-10 must be received by Medicare Administrative Contractors (MACs) on or before October 31, 2017.
HFS anticipates the CMS official publication of this extension and additional clarification regarding S-10 changes, no later than Friday September 29th and will notify clients when available.
If you have any questions please contact Eric Swanson at eric@hfssoft.com.
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
CMS published the Preliminary Public Use File (PUF) for the FY 2017 wage index and occupational mix on 5/15/2015. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2013 (FY Beginning from 10/1/12 to 9/30/2013). Hospitals will have until September 2, 2015 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 2017, Proposed Rule PUF:
FY 2017 May 15 2015 Wage Index PUF HFS Modified CSV 2552-10
CMS published an updated final FY 2016 wage index Public Use File (PUF) on July 30, 2015. This is the final file used for IPPS payments in FFY 2016.
The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2016, Final Rule PUF:
FY 2016 July 30 2015 Wage Index PUF HFS Modified CSV 2552-10
On February 20th, 2015 CMS issued updated monthly inflation factors to be used to update the Worksheet A-8-3 Therapy Guidelines for CAH providers providing contracted therapy services. The Transmittal is available on the CMS website at:
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2015-Transmittals-Items/R467PR1.html?DLPage=1&DLFilter=therapy&DLSort=1&DLSortDir=ascending
If you have any questions, please contact Eric Swanson at eric@hfssoft.com.
On Friday, March 13th, 2015, CMS issued Transmittal number 7 to the Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10. Transmittal 7 is effective for cost reporting periods ending on or after October 1, 2014.
The transmittal is available at the CMS website:
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2015-Transmittals-Items/R7P240.html?DLPage=1&DLSort=1&DLSortDir=descending
The major changes reflect Federal Fiscal Year 2015 IPPS Final Rule changes including:
- The addition of Worksheet S-2, Part I, lines 22.02 and 22.03 to identify newly merged hospitals and hospitals that undergo an involuntary reclassification from urban to rural.
- The addition of Worksheet-2, Part I, line 40, to identify hospitals that are subject to the Hospital Acquired Condition (HAC) reduction adjustment.
- The addition of Worksheet E, Part A, lines 22.01, 28.01 and 29.01 to compute the IME adjustment for managed care patients in a teaching hospital and revision to line 49 to add in the IME adjustment amount for managed care patients effective for cost reporting periods beginning on or after October 1, 2014.
- Instructional revisions to Worksheet E, Part A lines 35, 35.01 and 35.02 to calculate uncompensated care for newly merged hospitals in accordance with the 2015 IPPS Final Rule and Sole Community Hospitals that do not have a hospital uncompensated care payment amount determined by CMS.
- The addition of Worksheet E, Part A, lines 70.90, 70.91, and 100 through 104 to compute the value based purchasing adjustment amount and the hospital readmissions reduction adjustment amount for Medicare Dependent Hospitals that receive a hospital specific bonus payment amount.
- Instructional revisions to Worksheet E, Part A, line 34 for hospitals that undergo an involuntary reclassification from urban to rural as a result of CMS’ adoption of new standards for delineating new statistical areas.
- The addition of Worksheet E, Part A, line 70.99 and Exhibit 5 to reconcile the HAC reduction adjustment amount in accordance with the §3008 of the Patient Protection Affordable Care Act (ACA) of 2010.
Other changes include:
- The addition of Worksheet S-2, Part I, lines 81, 110 and 171 to identify long term care hospitals that are co-located in another hospital, hospitals that participate in the 410A Demo and hospitals claiming Medicare days for individuals enrolled in 1876 Medicare cost plans.
- Modified Worksheet E, Part A, lines 1.02, 1.03 and 1.04 to always split Medicare payments for IPPS services at October 1 of each Federal Fiscal year.
- Clarified instructions to Worksheet E-4, lines 2, 8 and 15 for Direct Graduate Medical Education (GME) FTEs.
- Revisions to Worksheets E, Part A; E, Part B; E-2; E-3, Parts I through VI; H-4; J-3; and M-3 to add lines for the Pioneer Accountable Care Organization demonstration payment adjustment in accordance with section 3022 of the ACA, effective for discharges occurring on or after April 1, 2014.
HFS is currently programming the software changes for transmittal 7 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, February 6th, 2015, CMS issued a Federal Register notice releasing a draft of revisions to the hospital 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. These provisions are effective for cost reporting periods beginning on or after October 1, 2014.
The draft is available at the CMS website:
http://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-2552-10.html?DLPage=1&DLSort=1&DLSortDir=descending
HFS is currently reviewing the draft forms and anticipates that CMS will release final forms and instructions in the summer of 2015. Once final forms are available, HFS will update the software and make the new form set available to current users of the 2552-10 software.
If you have any questions, please contact Eric Swanson at eric@hfssoft.com.