Transmittal 21 is effective for FYE on or after 10\/1\/2009 (i.e. must use T.21 for FYE 10\/1\/2009 and after), except for the H1N1 Vaccine changes which are effective for services on or after 9\/1\/2009.<\/p>\n
T.21 added three new ancillary cost centers, Cardiac Rehab, Hyperbaric Oxygen Therapy, and Lithotripsy. These will be available from our “pick list” of cost centers. W\/S S-3 part I, line 26, columns 5.01, 5.02, 6.01, and 6.02, for Observation Bed Days, are N\/A for FY Begin 10\/1\/2009 and after. No more “admitted” and not admitted split.<\/p>\n
Total observation bed days will now be subtracted in the calculation of E part A, line 3 (bed days available). W\/S E part A and L part I, line 4.01 or 5.01, are revised to INCLUDE in Total days, the Labor and Delivery Days from the NEW line 29 of S-3 part I. This is effective for FY Begin 10\/1\/2009 and after.<\/p>\n
W\/S S-2 line 21.01, column 2 was added for Pickle providers (“Y” indicates Pickle for operating DSH). If Pickle, then the allowable DSH percentage is automatically 35%, on E part A line 4.03.<\/p>\n
W\/S E-3 part I, lines 1.02, 1.04, 1.41, and 1.42 must be subscripted for column 1.01, if the FY overlaps 10\/1\/2009, as the LIP “factor” changed from 0.6229 to 0.4613. You only need to split payments on line 1.02 as we calculate the rest. W\/S M-3 line 14 calculation is phasing out the “limit”, over 5 years. For services through 12\/31\/2009 the 62.5% limitation remains. For services 1\/1\/2010 to 12\/31\/2011, the limit is 68.75%. For services 1\/1\/2012 to 12\/31\/2012 the limit is 75%. For services 1\/1\/2013 to 12\/31\/2013 the limit is 81.25%. For services on or after 1\/1\/2014, the limit is zero, or 100% reimbursement.<\/p>\n
W\/S M-4 added columns 2.01 and 2.02 for the H1N1 vaccine. Medical Supply cost, Total injections, and Medicare injections must be split between Pneumococcal, Influenza, H1N1 Only, and Influenza and H1N1 combined.<\/p>\n