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Part 2, Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10

CMS issued Transmittal 18 to the 2552-10 on December 29th, 2022.  Transmittal 18 has been issued with an effective date of Cost Reporting Periods Beginning on or After October 1, 2022 and implements many of the changes proposed through the PRA process including:

  • Addition of Exhibits for reporting:
    • Medicare bad debt by beneficiary,
    • Medicaid Eligible Day for DSH Eligible Hospitals,
    • Charity care charges by patient.
    • Total bad debts by patient.
  • Identification of permanent adjustments to the TEFRA target amount per discharge.
  • Identification of providers purchasing greater than fifty percent of its professional services from an unrelated organization located outside the main hospital’s local  area labor market.
  • Identification of the number of temporary expansion COVID-19 public health emergency acute care beds.
  • Revisions to Worksheet S-10.
  • Addition of Worksheet D-6 Parts I through IV to compute allogeneic HSCT acquisition costs as required under §1886(d)(5)(M) of the Social Security Act and in accordance with the statutory requirement under Section 108 of the Further Consolidated Appropriations Act, 2020 (Pub. L. 116-94) for reasonable cost payment.
  • Addition of Worksheet E-5 for the contractor to report the outlier reconciliation amount during cost report tentative settlement.

This Transmittal also implements FY 2023 IPPS final rule changes including DGME changes in regards to the Hershey litigation effective for cost reporting periods beginning on or after October 1, 2022. With revisions to Worksheet E-4 and the addition of Worksheet S-2, Part I, Line 68 to identify cost reports for periods beginning prior to October 1, 2022, that are eligible for the modified method of calculating direct GME payments to a teaching hospital when the hospital’s weighted FTE counts exceed their direct GME FTE cap in accordance with the FY 2023 IPPS final rule

Other Worksheet E-4 changes have been made to implement Sections 126, 127 and 131 of the CAA 2021.

This Transmittal also implements changes relating to the Community Health Access and Rural Transformation (CHART) model.  The CHART model is effective for discharges ending on or after January 1, 2024, for inpatient services, outpatient services, and CAH swing-bed services.

Other changes include the extension of the low volume adjustment and the Medicare Dependent Hospital (MDH) program, but these changes are subject to subsequent Law provisions.

HFS is evaluating all finalized changes and will be working with CMS to implement and receive approval of the changes within the software.

CMS Published Transmittal 18 at the below link to the CMS website:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Transmittals/r18p240i

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