Preliminary FFY 2019 PUF

May 22nd, 2017 No comments

CMS published the Preliminary Public Use File (PUF) for the FY 2019 wage index and occupational mix on 5/19/2017. This file reflects the Worksheet S-3, Parts II and III wage data from cost reports for Fiscal Year (FY) 2015 (FY Beginning from 10/1/14 to 9/30/2015). Hospitals will have until September 1, 2017 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 2019,

Click here to download the Preliminary PUF: FY_2019_Preliminary_S3_PUF_HFS_Modified.csv

April 28th, 2017 Final FFY 2018 PUF

May 1st, 2017 No comments

CMS published the Final FY 2018 wage index and occupational mix data PUFs on their Web page. Hospitals will have until May 30, 2017 to verify their data and submit correction requests to both CMS and their MAC to correct errors due to CMS or MAC mishandling of the final wage and occupational mix data.

Changes to data will be limited to situations involving errors by CMS or the MAC that the hospital could not have known about before review of the final April PUFs. CMS and the MACs must receive all requests by this date via mail and email to the addresses above. NOTE: CMS emphasizes that data that were incorrect in the preliminary or January wage index data PUFs, but for which no correction request was received by the February 17, 2017, deadline, will not be changed at this stage for inclusion in the wage index. Each correction request must include all information and supporting documentation needed for CMS and the MAC to determine whether or not the hospital’s request meets the criteria for a correction to their data at this point in the wage index development. The MACs and DAC will review each request upon receipt and consult to determine whether or not the request qualifies for correction of the final wage or occupational mix data.

The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Final Federal Fiscal Year 2018, April 28, 2017 PUF:

FY 2018 April 18, 2017 Wage Index PUF HFS CSV 2552-10

CMS issues Transmittal 13 to the Provider Cost Reporting Forms and Instructions, Chapter 29, Form CMS-222-92

February 17th, 2017 No comments

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.

 

 

January 30, 2017 FFY 2018 PUF

January 31st, 2017 No comments

CMS published an updated Public Use File (PUF) for the FY 2018 wage index and occupational mix on 1/30/2017. 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). These data will have been desk reviewed and verified by the MACs before being published.

The following file has been created and can be downloaded and used with the Wage Index Verification Tool for the Federal Fiscal Year 2018, January 30, 2017 PUF:

FY 2018 January 30, 2017 Wage Index PUF HFS CSV 2552-10

CMS issues Transmittal 17 to the Provider Cost Reporting Forms and Instructions, Chapter 11, Form CMS-1728-94

January 31st, 2017 No comments

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

CMS issues Transmittal 10 to the Provider Cost Reporting Forms and Instructions, Chapter 40 Form CMS-2552-10

January 30th, 2017 No comments

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.

 

Categories: Cost Report News, Hospitals Tags:

CMS issues Transmittal 7 to the Provider Cost Reporting Forms and Instructions, Chapter 41 Form CMS-2540-10

October 24th, 2016 No comments

The Skilled Nursing Facility, 2540-10 was updated to Transmittal 7 by CMS, on August 19, 2016. Transmittal 7 is effective for cost reporting periods beginning on or after October 1, 2015.

The primary purpose of the transmittal was to incorporate statutory reporting requirements to facilitate hospice payment reforms pursuant to Section 3132 of the Patient Protection and Affordable Care Act (ACA).  In addition, this transmittal requires SNF facilities with FQHC units to file a separate Form 224-14 cost report for cost reporting periods beginning on or after October 1, 2014.

HFS was approved for Transmittal 7 on October 21, 2016. Software is in testing and will be released in the next week.  The full transmittal is available at the CMS website:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R7PR241.pdf

If you have any questions, please contact Eric Swanson at eric@hfssoft.com.

 

Categories: General Information Tags:

W/S S-10 Implementation Delayed Per 2017 IPPS Final Rule

August 4th, 2016 No comments
On Friday July 29, 2016 HFS posted and issued an email highlighting CMS Transmittal number 1681 to Publication 100-20 that provided guidance for accepting FY 2014 amended cost reports from hospitals requesting to revise Worksheet S-10 in light of CMS’s proposal to begin using Worksheet S-10 data to determine uncompensated care payments starting in FY 2018.

On August 2, 2016 CMS published the FY 2017 Final Rule and in this rule they delayed the implementation of using the Worksheet S-10.  Below is an excerpt relating to this with the link to the final rule also shown below.

At this time, we are not finalizing a future transition to using Worksheet S-10 data to determine the amounts and distribution of uncompensated care payments.  Specifically, we had proposed to use a 3-year transition beginning in FY 2018 where we use a combination of Worksheet S-10 and proxy data until FY 2020 when all data used in computing the uncompensated care payment amounts to be distributed would come from Worksheet S-10.  In light of public comments, we believe it would be appropriate to institute certain additional quality control and data improvement measures to the Worksheet S-10 instructions and data prior to moving forward with incorporation of Worksheet S-10 data into the calculation of Factor 3. Consequently, we are not finalizing our proposal to begin to incorporate Worksheet S-10 data into the computation of Factor 3 for FY 2018. In light of the significant concerns expressed by commenters regarding the Worksheet S-10 data, we are postponing the decision regarding when to begin incorporating data from Worksheet S-10 and proceeding with revisions to the cost report instructions for Worksheet S-10. We expect data from the revised Worksheet S-10 to be available to use in the calculation of Factor 3 in the near future, and no later than FY 2021. With regard to how Factor 3 will be computed in FY 2018 and subsequent years, we intend to explore whether there is an appropriate proxy for uncompensated care that could be used to calculate Factor 3 until we determine that data from the revised Worksheet S-10 can be used for this purpose. We will undertake further notice-and-comment rulemaking to address the issue of the appropriate data to use to determine Factor 3 for FY 2018 and subsequent fiscal years.

https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-18476.pdf

If you have any questions or problems with the above, please contact support@hfssoft.com.

 

 

 

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Categories: Hospitals Tags:

CMS issues Transmittal 1681 to Publication 100-20

July 19th, 2016 No comments

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.

Preliminary FFY 2018 PUF

May 20th, 2016 No comments

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