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Form CMS-2552-96 Update Transmittals 17 and 18

Form CMS-2552-96 Update Transmittals 17 and 18. Don Fry, Director, KPMG LLP, Los Angeles, CA John Flood, Manager, KPMG LLP, Los Angeles, CA HFMA Southern California Chapter Educational Session March 18, 2008. Summary of effective dates and significant changes .

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Form CMS-2552-96 Update Transmittals 17 and 18

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  1. Form CMS-2552-96 UpdateTransmittals 17 and 18 Don Fry, Director, KPMG LLP, Los Angeles, CA John Flood, Manager, KPMG LLP, Los Angeles, CA HFMA Southern California Chapter Educational Session March 18, 2008

  2. Summary of effective dates and significant changes The effective dates for instructional changes vary due to different implementation dates. • TRANSMITTAL 17 • Worksheet E Part A – Effective for discharges occurring on and after October 1, 2006, this worksheet incorporates revisions impacting Medicare dependent hospitals (MDHs) • Changes to the electronic cost reporting specifications are effective for cost reporting periods ending on or after December 31, 2006. • TRANSMITTAL 18 • Worksheet S-3 Part II – the instructions will be revised to accommodate the inclusion of fees and hours for legal and consulting services in contract administrative and general costs.

  3. Worksheet S-2, Line 21.03 (T17 change) • Column 5 was added to capture the hospital’s Core-Based Statistical Area (CBSA) code: • Column 5 should be used for cost reporting periods ending on and after December 31, 2006.

  4. Worksheet S-2, Line 21.06 • Line 21.06 was added to provide a simplified question to initiate the TOPS calculation: • The line is used for cost reporting periods ending on and after January 1, 2006. • The response impacts the TOPS calculation on Worksheet E Part B, Line 1.06.

  5. Worksheet S-2, Lines 40.01 through 40.03 • To capture home office identifying information when the provider is part of a chain: • Originally added in T16; FI / MAC name and FI / MAC number added in T17.

  6. Worksheet S-3 Part II (T18 change) • CLARIFICATION TO INSTRUCTIONS FOR LINE 9.03 • Line 9.03 - Contract management and administrative services associated with non-overhead cost centers that are included in the wage index are to be included on Worksheet S-3, Part II, line 9.03 (“Contract management and administrative”). Examples are, Director of Pediatrics, Laboratory Services Administrator, Blood Bank Manager, Administrative Assistant in the Department of Cardiology, SICU Ward Clerk, Medical Secretary in the Obstetrics Department. Only the personnel costs (wages and wage-related costs) associated with the contract may be included in the wage index. Travel expense, equipment, supplies, and other overhead fees associated with the contract must not be included.

  7. Worksheet S-3 Part II (T18 change) • CLARIFICATION TO INSTRUCTIONS FOR LINE 22.01 • Line 22.01 - Any contract service that is included on Worksheet A, line 6, column 2 (“General Service – Administrative and General, Other”) is to be included on Worksheet S-3, Part II, line 22.01 (“Overhead Costs – Administrative & General under contract”). Contract information services, legal services, tax preparation services, and cost report preparation services are examples of contract labor costs that would be included on Worksheet S-3, Part II, line 22.01. Contract workers who assist and perform equivalent duties as directly hired A&G employees (line 22) would be included on line 22.01.

  8. Worksheets A, B/B-1, S-2, D-6 (T17 change) • NEW COST CENTER • Line 85.20--Record the costs of islet cells transplants (extracted from pancreases) in accordance with CR 5505 effective for discharges on or after 10/1/04. Use non-standard cost center code 8620 to identify this cost center. • Line 23.07--Enter the certification date for the islet transplant center on Worksheet S-2. • A new separate copy of Worksheet D-6 must be completed for Islet Cells Transplants.

  9. Worksheet D Part V – ambulance service revisions • Revised instructions for Columns 5, 5.01 and 5.02 to reflect the elimination of ambulance fee payments for services rendered on or after January 1, 2006: • Added to the instructions for Columns 5, 5.01 and 5.02: Do not subscript line 65 for cost reporting periods beginning on or after 1/1/2006, as the ambulance PPS payment blend will transition to 100 percent fee based payments. • Added to the instructions for Columns 9, 9.01 and 9.02: Once ambulance payment has transitioned to 100 percent of the fee amount (services rendered on or after 1/1/2006), line 56 will no longer include fee schedule payments.

  10. Worksheet D-1 Lines 59.05-59.07 – LTCH budget neutrality factors updated • Line 59.05 through 59.07--Compute the reduced inpatient cost per discharge for each period by applying the appropriate budget neutrality factor to the allowable inpatient cost per discharge reported on line 59.01. Budget neutrality factors have been identified in the Federal Register dated August 30, 2002, page 56034, June 6, 2003, page 34153, and May 7, 2004, page 25703 and are reflected as follows: • 93.40 percent for discharges occurring from 10/1/2002 through 6/30/2003 • 94.00 percent for discharges occurring from 7/1/2003 through 6/30/2004 • 99.50 percent for discharges occurring from 7/1/2004 through 6/30/2005 • 1.000 (a 0.0 percent reduction) for discharges occurring from 7/1/2005 through 6/30/2006 (70 FR 24202) • 1.000 (a 0.0 percent reduction) for discharges occurring from 7/1/2006 through 6/30/2007 (70 FR 24202) • 1.000 (a 0.0 percent reduction) for discharges occurring from 7/1/2007 through 6/30/2008

  11. Worksheet E Part A, MDH changes • IMPLEMENTED AFTER T16 RELEASED, MADE “OFFICIAL” IN T17 • For Cost reporting periods overlapping October 1, 2006, MDH providers must subscript column 1 for lines 1-2, 3.21-3.24, 4.03-4.04 and 5-7. Enter in column 1 the applicable payment data for the period prior to October 1, 2006 and enter in column 1.01 the applicable payment data for the period on or after October 1, 2006. • Added to Line 4.03--In addition for MDH providers for cost reporting periods overlapping October 1, 2006, the rural 12 percent DSH payment cap does not apply for discharges occurring on or after October 1, 2006. Enter in column 1 the percentage to be applied for discharges occurring prior to October 1, 2006 and enter in column 1.01 the percentage to be applied for discharges occurring on or after October 1, 2006.

  12. Worksheet E Part A, MDH changes (continued) • IMPLEMENTED AFTER T16 RELEASED, MADE “OFFICIAL” IN T17 • Line 7-- Sole community hospitals are paid the highest rate of the Federal payment rate, the hospital-specific rate (HSR) determined based on a Federal fiscal year 1982 base period (see 42 CFR 412.73),or the hospital-specific rate determined based on a Federal fiscal year 1987 base period. (See 42 CFR 412.75.) For discharges occurring on or before October 1, 2006, Medicare dependent hospitals are paid the highest of the Federal payment rate, or the Federal rate plus 50 percent of the amount of the excess over the Federal rate of the higher of either the 1982 base period, or the 1987 base period hospital specific rate. For discharges occurring on or after October 1, 2006 Medicare dependent hospitals are paid the highest of the Federal payment rate, or the Federal rate plus 75 percent of the amount of the excess over the Federal rate of the highest rate for the 1982, 1987 or the 2002 base period hospital specific rate. For SCHs and Medicare dependent/small rural hospitals, enter the applicable hospital-specific payments.

  13. Worksheet E Part A, MDH changes (continued) • IMPLEMENTED AFTER T16 RELEASED, MADE “OFFICIAL” IN T17 • Line 8--For SCHs, enter the greater of line 6 or 7. For MDHs (for discharges occurring on or after October 1, 1997, and before October 1, 2006), if line 6 is greater than line 7, enter the amount on line 6. Where line 7 is greater than line 6, enter the amount on line 6, plus 50 percent of the amount that line 7 exceeds line 6. For MDH discharges occurring on or after October 1, 2006 and beforeOctober 1, 2011, if line 6 is greater than line 7, enter the amount on line 6. Where line 7 is greater than line 6, enter the amount on line 6, plus 75 percent of the amount that line 7 exceeds line 6.Hospitals not qualifying as SCH or MDH providers will enter the amount from line 6.

  14. Worksheet E Part A, MDH changes (continued) • EXAMPLE (some lines omitted for space purposes)

  15. Worksheet E Part B, Line 1.06 • REVISED INSTRUCTIONS TO IMPLEMENT TOPS FOR SMALL RURAL NON-SOLE COMMUNITY HOSPITALS • Line 1.06--Enter the transitional corridor payment amount calculated based on the following: (only revisions shown below) • For cost services rendered from January 1, 2006 through December 31, 2008, calculate this line when the response to Worksheet S-2, line 21.06 is”Y”. • In accordance with DRA 2005, section 5105, for services rendered January 1, 2006, through December 31, 2008, rural hospitals with 100 or fewer beds that are not SCHs are entitled to hold harmless TOPs: • a. For services rendered January 1, 2006, through December 31, 2006, if Worksheet S-2, line 21.06, is “Y”, enter 95 percent of (line 1.04 minus line 1.02). • b. For services rendered January 1, 2007, through December 31, 2007, if Worksheet S-2, line 21.06, is “Y”, enter 90 percent of (line 1.04 minus line 1.02). • c. For services rendered January 1, 2008, through December 31, 2008, if Worksheet S-2, line 21.06, is “Y”, enter 85 percent of (line 1.04 minus line 1.02).

  16. K-Series (Hospice) Worksheets (T17) • NEW COST CENTERS (Affects K, K-1, K-2, K-3, K-4 and K-5) • Line 10.20 - Nursing Care–Continuous Home Care.--Enter the continuous home care portion of costs for nursing services provided by a registered nurse, licensed practical nurse or licensed vocational nurse as specified in the plan of care by or under the supervision of a registered nurse at the patient’s residence. • Line 18.20 - Home Health Aide and Homemaker-Continuous Home Care.--Enter the continuous care portion of cost for home health aide and/or homemaker services provided as specified in the plan of care and under the supervision of a registered nurse. • Line 20.30 - Analgesics.--Enter the cost of analgesics. • Line 20.31 - Sedatives/Hypnotics.--Enter the cost of sedatives/hypnotics. • Line 20.32 - Other Specify.—Specify the type and enter the cost of any other drugs which cannot be appropriately identified in the drug cost center already listed.

  17. 2552-96 FORMS AND INSTRUCTIONS ARE AVAILABLE VIA CMS WEB SITE OR E-MAIL • CMS web site URL for cost reporting forms: • http://www.cms.hhs.gov/Manuals/PBM/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS021935 • PRESENTATION IS AVAILABLE VIA E-MAIL Send an e-mail request to jflood@kpmg.com – the file will be an Adobe-compatible PDF file. You’ll need Adobe Acrobat Reader to view it. If you don’t have Acrobat Reader, you can download it free of charge at http://www.adobe.com.

  18. Questions? ? ? ?

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