CMS issues Transmittal 12 to the Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10
The Hospital and Hospital Health Care Complex Cost Report, Form CMS-2552-10 was updated to Transmittal 12 by CMS, on November 17, 2017. Transmittal 12 is effective for cost reporting periods ending on or after August 31, 2017.
This transmittal updates Chapter 40, Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), by including subsection (d) Puerto Rico providers as eligible for the electronic health record (EHR) incentive payments and by accommodating the Rural Community Hospital Demonstration Project (§410A Demonstration) adjustment. This transmittal also accommodates the ability for a provider to elect and sign the Certification and Settlement Summary page of the Medicare cost report using an electronic signature pursuant to the FY 2018 IPPS Final Rule.
Changes include:
Worksheet S:
• Added check box to the certification and settlement summary statement for electronic signature submission on cost reporting periods ending on or after December 31, 2017.
Worksheet S-2, Part I:
• Modified instructions for line 39 to reflect the revised eligibility criteria and corresponding low-volume adjustment of 25 percent, effective for discharges occurring on or after October 1, 2017.
• Modified instructions for line 60 for nursing school and allied health education (NAHE) activities to separately identify each individual program reimbursed in accordance with the provisions of 42 CFR 413.85 where reimbursement is made on a reasonable cost basis.
• Added lines 98 through 98.06 related to titles V and XIX reimbursement for critical access hospitals (CAH), reasonable compensation equivalents (RCE), and pass-through costs. These questions were previously addressed by HFS on a non-CMS Worksheet S-2. Part IX.
• Modified line 110 for the Rural Community Hospital Demonstration Project (also known as the §410A Demonstration), as extended by §15003 of the 21st Century Cures Act of 2016, to initiate the calculation of added lines on Worksheet E, Part A, lines 200 through 218, and Worksheet E-2, lines 200 through 215. This calculation was previously addressed by HFS on non-CMS Worksheet E, Part H.
• Added line 111 to identify providers participating in the Frontier Community Health Integration Project (FCHIP) Demonstration.
• Modified questions 167 and 169 to accommodate subsection (d) Puerto Rico providers eligible for the electronic health record (EHR) incentive payment for federal fiscal years 2016 through 2021, in accordance with the CCA 2016, Division O, Title VI, §602.
Worksheet S-3, Part I:
• Added line 33.01 to capture site neutral days and discharges for long term care hospitals (LTCH).
Worksheet A:
• Expanded the instructions for lines 20 and 23 (nursing school and paramedical education) programs to capture the costs of each program on a separate subscript of line 20 and/or line 23, as applicable.
• Added line 77 to capture allogeneic stem cell acquisition costs as defined in CMS Pub. 100-04, chapter 4, §231.11.
• Added line 93.99 to capture the costs of providing hospital-based partial hospitalization program (PHP) services as defined in §1861(ff) of the Act.
Worksheet A-8:
• Added instructions for line 19 to report the nursing school tuition offset adjustment and the allied health/paramedical education tuition offset adjustment. Note that tuition offset adjustments are to be made on Worksheet A-8 and not on Worksheet B-2.
Worksheets B, Part I and B-1:
• Shaded line 116 in columns 19, 21, and 22. This change prevents the allocation of Non-Physician Anesthetists and Interns and Residents costs to the hospital-based Hospice.
Worksheets D, Parts III and IV:
• Modified the worksheets by adding post step-down adjustment columns for nursing school and allied health. Post step-down adjustments were previously accommodated by HFS using non-CMS columns 11-13 on Worksheet D, Part III and non-CMS columns 21-24 on Worksheet D, Part IV
Worksheets E, Part A; E, Part B; E-2, E-3, Parts I through IV; H-4; J-3; M-3; and N-4:
• Added two lines to each reimbursement settlement worksheet to capture demonstration payment adjustments before sequestration, and demonstration payment adjustments after sequestration.
Worksheet E, Part A:
• Added a dedicated line 70.50 to capture the 410A demonstration project payment adjustment.
• Added lines 200 through 218 to calculate the §410A demonstration project payment adjustment amount for inpatient services.
Exhibit 4 (Low-volume adjustment):
• Modified the instructions to calculate the low-volume adjustment payment at 25 percent for services rendered on or after October 1, 2017.
• Shaded line 17.01 (net organ acquisition costs), to eliminate it from the low-volume adjustment payment calculation.
Exhibit 5 (Hospital acquired condition (HAC) adjustment):
• Shaded line 17.01 (net organ acquisition costs), to eliminate it from the HAC adjustment calculation.
Worksheet E, Part B:
• Added line 4.01 to capture the operating outlier reconciliation amount for operating expenses related to outpatient prospective payment (PPS) services.
•Worksheet E-1, Part II:
• Modified the instructions to accommodate the calculation EHR incentive payments for Puerto Rico subsection (d) hospitals in accordance with CAA 2016, Division O, Title VI, §602. This worksheet is not completed by original subsection (d) hospitals for cost reports beginning on or after October 1, 2016.
HFS is currently programming the software changes for transmittal 12 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/R12P240.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending
If you have any questions please contact eric@hfssoft.com.