Southwest Consulting Associates Blog

FY 2020 IPPS Final Rule Posted

Posted by Jamie Pennington on Aug 2, 2019 4:40:07 PM

The FY 2020 Inpatient Prospective Payment System (IPPS) Final Rule was put on display for public inspection on August 2, 2019, and is scheduled to be published in the Federal Register on August 16, 2019.  The pre-publication version can be viewed HERE or on the FY 2020 IPPS Final Rule homepageThese changes will go into effect October 1, 2019.  

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Topics: Medicare DSH Reimbursement, Industry Updates, S-10, regulations, proposed rule, worksheet s-10, factor 3, uncompensated care payment, ipps rule, provider reimbursement

FY 2020 IPPS Proposed Rule

Posted by Jamie Pennington on Apr 24, 2019 3:23:43 PM

The FY 2020 Inpatient Prospective Payment System (IPPS) Proposed Rule was put on display for public inspection on April 23, 2019, and is scheduled to be published in the Federal Register on May 3, 2019.  The pre-publication version can be viewed HERE or on the FY 2020 IPPS Proposed Rule homepage.  If finalized, these changes will go into effect October 1, 2019.  All public comments to the proposed rule are to be received by 5 pm EST on Monday, June 24, 2019.

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Topics: Medicare DSH Reimbursement, Industry Updates, S-10, regulations, proposed rule, worksheet s-10, factor 3, uncompensated care payment, ipps rule, provider reimbursement

FFY 2017 MAC Letters & Aberrant Worksheet S-10 Data

Posted by Jeff Norman on Apr 10, 2019 11:20:14 AM

On April 8, 2019, SCA was provided multiple copies of a MAC letter informing hospitals of potentially aberrant data reported on Worksheet S-10 for federal FY 2017.  While we have only seen a few letters to date, it is our understanding that this is a CMS initiative affecting many hospitals. Here is what we have been told at this point:

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Topics: uncompensated care, S-10, worksheet s-10, factor 3, uncompensated care payment, cost to charge ratio, Medicare Cost Report, S-10 audit, provider reimbursement

FFY 2017 SSI Ratios Posted to CMS Website for Medicare DSH

Posted by Jamie Pennington on Apr 4, 2019 4:57:30 PM

CMS posted the FFY 2017 SSI ratios to their website.  The FFY 2017 SSI ratio file (DSH Adjustment and 2016-2017 File [ZIP, 246KB]) can be found in the Downloads section of CMS' Disproportionate Share Hospital (DSH) webpage or by following the link below:

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, SSI Recalculations, factor 3, ssi ratio, uncompensated care payment

FFY 2016 SSI Ratios Posted to CMS Website

Posted by Jamie Pennington on Mar 19, 2018 3:11:26 PM

CMS just posted the FFY 2016 SSI ratios to their website.  The FFY 2016 SSI ratio file (DSH Adjustment and 2015-2016 File [ZIP, 248KB]) can be found in the Downloads section of CMS' Disproportionate Share Hospital (DSH) webpage or by following the link below:

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, SSI Recalculations, factor 3, ssi ratio, uncompensated care payment

What You Need To Know About TDL 180029 & Worksheet S-10

Posted by Jamie Pennington on Oct 24, 2017 1:07:00 PM

On October 20, 2017, CMS issued another Technical Direction Letter (TDL) extending the deadline for all IPPS hospitals to submit revised or initial FFY 2014 and 2015 Worksheet S-10’s to January 2, 2018.  Southwest Consulting Associates confirmed this directly with CMS' Division of Acute Care and is monitoring the CMS website for a posted notice, which CMS also stated would be available shortly.  Until the official notice is posted, please contact your MAC for additional information.

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, S-10, worksheet s-10, factor 3

CMS Transmittal 11 and Cost Report Worksheet S-10 Instructions

Posted by Michael Newell on Oct 5, 2017 10:05:00 AM

Last week, September 29, 2017, CMS issued Transmittal 11 that makes a number of revisions to the instructions for reporting data on cost report Worksheet S-10.  These instructions need to be incorporated into any FFY 2014 & FFY 2015 Worksheet S-10 revisions providers are working to submit by the October 31, 2017 deadline and then for any future year submissions. In particular, the changes include:

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, S-10, worksheet s-10, factor 3

TDL Issued, Worksheet S-10 Revision Deadline Extended For ALL

Posted by Jamie Pennington on Oct 4, 2017 4:03:56 PM

As a result of Hurricanes Harvey, Irma and Maria, CMS posted a notice on its website last month granting a 31-day extension to IPPS hospitals in Texas, Louisiana, Florida, Georgia, South Carolina, Puerto Rico and the U.S. Virgin Islands to submit FFY 2014 and FFY 2015 revised Worksheet S-10's.  CMS subsequently issued a Technical Direction Letter (TDL) extending the same 31-day extension to file updated FFY 2014 and 2015 Worksheet S-10’s to October 31, 2017 for ALL IPPS providers.  

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, S-10, worksheet s-10, factor 3

CMS Extends Cost Report Worksheet S-10 Revision Deadline

Posted by Jamie Pennington on Sep 22, 2017 10:34:54 AM

Earlier this week, CMS posted a notice on its website granting a 31-day extension to IPPS hospitals in Texas, Louisiana, Florida, Georgia, South Carolina, Puerto Rico and the U.S. Virgin Islands to submit FFY 2014 and FFY 2015 Worksheet S-10's.  This comes on the heels of Hurricane Harvey, Irma and Maria, the President declaring a state of emergency and the HHS Secretary declaring a public health emergency for Texas, Louisiana, Florida, Georgia, South Carolina, Puerto Rico and the U.S. Virgin Islands.  Both the President and HHS Secretary's actions allow CMS to put in place programmatic waivers based on Section 1135 of the Social Security Act.

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, S-10, worksheet s-10, factor 3

Robust Factor 3 Comments Not Enough to Sway CMS & 2018 IPPS Final Rule

Posted by Michael Newell on Sep 5, 2017 12:53:25 PM

As we all now know, CMS proposed transitioning to the use of uncompensated care cost per worksheet S-10 in the IPPS 2017 rulemaking cycle. For many reasons that we have discussed in the past and that CMS reiterated in the last rulemaking cycle, that plan was not finalized. And although many people were left thinking that CMS was going to make some reforms to the definitions and reporting processes before going forward, they did leave the door open just a bit last year with regarding to moving forward with the change to S-10 in FY 2018. As we now know, they chose to squeeze through that opening and have finalized plans to begin the transition to using worksheet S-10 beginning in FY 2018. As overall justification, CMS stated:

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, S-10, regulations, final rule, worksheet s-10, factor 3

About This Blog

The climate of provider reimbursement is ever-changing and this blog is intended to keep you up-to-date on the latest information regarding:

  • DSH Reimbursement
  • 340B Pharmacy Drug Discount Program
  • Compliance Issues
  • Litigation Surrounding Provider Reimbursement

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