The 2018 IPPS Final Rule was put on display for public inspection on August 2, 2017 and is scheduled to be published in the Federal Register on Monday, August 14, 2017. The pre-publication version can be viewed HERE (Medicare DSH begins on page 771). SCA will be reviewing and analyzing the details of the final rule and its components and we will provide more detailed conclusions soon.
Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, proposed rule
On June 7, 2017, the Provider Reimbursement Review Board (PRRB) issued Alert 12 via email notifying Providers of a change of address for the CMS Office of Hearings, which handles the appeals for the PRRB. The Alert was just recently posted to the CMS website and can be read in full HERE. As of June 19, 2017, any correspondence sent to the PRRB should be sent to:
Topics: Industry Updates, PRRB
We posted last week that the E&C Committee held a hearing July 18, 2017, with witnesses from the Office of Pharmacy Affairs, the Government Accountability Office and the Office of Inspector General. The purpose of the hearing was to review HRSA’s oversight of the 340B Drug Pricing Program, and how the program specifically impacts patients, providers, manufacturers and other stakeholders.
Topics: Industry Updates, 340B, 340b compliance
On Thursday, July 13, 2017, CMS announced that “amended FY 2014 cost reports due to revised or initial submissions of Worksheet S-10 received by Medicare Administrative Contractors on or before September 30, 2017, will be uploaded to the Healthcare Cost Report Information System by December 2017”. In its announcement, CMS stated that “hospitals have requested CMS provide them with an additional opportunity to revise the Worksheet S-10 submitted with their FY 2014 cost reports (starting on or after October 1, 2013, and prior to October 1, 2014)”.
Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, worksheet s-10, factor 3, CMS transmittal
On July 7, 2017, CMS posted the FFY 2015 SSI ratios to their website. The FFY 2015 SSI ratios should be used for computing the Disproportionate Share Hospital payment for cost reporting periods beginning on or after October 1, 2014, and before October 1, 2015. The FFY 2015 SSI ratio file (DSH Adjustment and 2014-2015 File [ZIP, 266KB]) can be found in the Downloads section of CMS' Disproportionate Share Hospital (DSH) webpage or by following the link below:
Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, SSI Recalculations, ssi ratio
On Friday, June 30, 2017, CMS released Transmittal 1863 (beginning on page 2), which included, among other items, guidance for MACs to follow for accepting cost reports containing revised Worksheet S-10 information. Similar to last year's Transmittal 1681, in order for MACs to accept amended cost reports due to revisions to Worksheet S-10 for FY 2015, CMS has put providers on notice by stating that “hospitals must submit their amended cost report containing the revised Worksheet S-10…no later than September 30, 2017.” CMS added, “Submissions received on or after October 1, 2017 will not be accepted.”
Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, worksheet s-10, factor 3, CMS transmittal
The FY 2018 IPPS proposed rule was published in the Federal Register on April 28, 2017. All comments to the rule were to be submitted to CMS by Tuesday, June 13, 2017. Like in past years, Southwest Consulting Associates (SCA) performed extensive analysis of the proposed rule and submitted comments in response to CMS’ FY 2018 IPPS Notice of Proposed Rulemaking (NPRM). SCA’s comments primarily related to the proposed changes in the payment adjustment for Medicare Disproportionate Share Hospitals (DSH) including the Uncompensated Care (UC) payment component.
Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, Industry Updates, S-10, regulations, proposed rule, worksheet s-10
The 2018 IPPS Proposed Rule was published in the Federal Register on April 28, 2017. If finalized, these changes will go into effect October 1, 2017. The published version can be viewed HERE. Public comments will be accepted until 5 p.m. EDT on June 13, 2017. Below is SCA’s brief, yet comprehensive summary on the Medicare DSH/Uncompensated Care payment portion of the proposed rule as it will affect DSH hospitals.
Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, Compliance, Industry Updates, S-10, regulations, proposed rule, healthcare finance, worksheet s-10
The 2018 IPPS Proposed Rule was put on display for public inspection on April 14, 2017 and is scheduled to be published in the Federal Register on Friday, April 28, 2017. The pre-publication version can be viewed HERE. All public comments to the proposed rule are to be received by 5 p.m. EST on Tuesday, June 13, 2017. SCA will be reviewing and analyzing the details of the proposed rule and its components, and we will provide our conclusions soon.
Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, proposed rule
Today, Health Resources and Services Administration (HRSA) released the long-awaited 340B Program Omnibus Guidelines (Mega-Guidance) for public viewing on the Federal Register website. According to the site, the Mega-Guidance will officially be published on Friday, August 28, 2015 and public comments should be submitted on or before TUESDAY, OCTOBER 27, 2015 (60 days after the Federal Register publication date). The pre-publication document can be found at:
Topics: Compliance, Industry Updates, 340B