Southwest Consulting Associates Blog

2018 IPPS Final Rule: "What To Do Now" Recommendations

Posted by Michael Newell on Aug 24, 2017 8:45:00 AM

Now that the FY 2018 IPPS final rule has been published, we think that you need to do some things that are both in the here and now AND in the future.  Here are some of the top priorities that we are managing for our clients:

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

2018 IPPS Final Rule: Worksheet S-10 Comes Off the Bench

Posted by Jamie Pennington on Aug 22, 2017 9:49:09 AM

The 2018 IPPS Final Rule was published in the Federal Register on August 14, 2017. The finalized changes will go into effect October 1, 2017. The Federal Register version can be viewed HERE (Medicare DSH begins on page 38189).  Below is SCA’s brief, yet comprehensive summary on the Medicare DSH/Uncompensated Care payment portion of the final rule as it will affect DSH hospitals.

 

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, Compliance, Industry Updates, S-10, regulations, final rule, worksheet s-10

CMS Posts 2018 IPPS Final Rule: Worksheet S-10 IS A GO!

Posted by Jamie Pennington on Aug 2, 2017 4:05:30 PM

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.

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, proposed rule

2018 IPPS Proposed Rule: Recommendations in Advance of Final Rule

Posted by Jeff Norman on Jul 31, 2017 4:10:58 PM

The FY 2018 IPPS proposed rule was published April 28, 2017. Public comments have been submitted and we are awaiting the final rule.  For reference, the 2017 IPPS final rule was posted the first week in August 2016 so we are on the cusp on the 2018 final rule.  

 

In our last proposed rule post, while we stated that there was a brief moment of deja vu with regards to using Worksheet S-10 to distribute the uncompensated care payment to qualifying Medicare DSH hospitals for FY 2018, we also stated that based on the language used in the proposed rule, we believe that the change will stick this time.  Despite challenges on the accuracy of Worksheet S-10 data, CMS goes out of their way to lay out the reasoning for using S-10 now.  And, with the issuance of Transmittal 1863 and the notice about FY 2014 S-10 revisions, our case may be even stronger now.   From experience, we all know that anything can happen but we think Medicare DSH hospitals should take notice (and quickly) with this proposed rule, subsequent Transmittal and Notice and prepare themselves as best they can to deal with this significant change. Here’s what we recommend hospital’s be working on in advance of the final rule, in order of priority.

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, S-10, regulations, final rule, proposed rule, worksheet s-10, CMS transmittal

CMS Posts FY2014 Worksheet S-10 Revisions Announcement

Posted by Kyle Pennington on Jul 13, 2017 5:44:09 PM

 

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)”.

 

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, worksheet s-10, factor 3, CMS transmittal

FFY 2015 SSI Ratios Posted to CMS Website

Posted by Jamie Pennington on Jul 7, 2017 2:46:32 PM

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:

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, SSI Recalculations, ssi ratio

CMS Issues Transmittal 1863 - FY2015 Worksheet S-10

Posted by Kyle Pennington on Jul 6, 2017 3:58:23 PM

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 1681in 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.”

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, worksheet s-10, factor 3, CMS transmittal

IPPS Proposed Rule 2018: Factor 3 - CMS Digging Heels In

Posted by Michael Newell on Jun 22, 2017 1:10:34 PM

On April 28, 2017, CMS published the FFY 2018 IPPS Proposed Rule in the Federal Register.  Go HERE for our summary of the Medicare DSH/Uncompensated care payment portion of the rule.  After years of discussion to use Worksheet S-10 uncompensated care data to distribute the Medicare DSH/UC pool always ending with CMS “kicking the can down the road”, it appears that CMS has finally dug their heels in.  Who else just had a moment of deja vu?  

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

2018 IPPS Proposed Rule: Factor 3

Posted by Jeff Norman on Jun 20, 2017 3:07:15 PM

On April 28, 2017, CMS published the FFY 2018 IPPS Proposed Rule in the Federal Register.  Go HERE for our summary of the Medicare DSH/Uncompensated care payment portion of the proposed rule.  After years of discussion on Worksheet S-10 and false starts on the use of uncompensated care data for Medicare DSH/UC pool distribution purposes, CMS appears to finally be moving forward with implementation.  Did anyone else have a moment of deja vu?  

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

2018 IPPS Proposed Rule Comment Letter Submitted to CMS

Posted by Jamie Pennington on Jun 15, 2017 11:39:13 AM

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.

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, Industry Updates, S-10, regulations, proposed rule, worksheet s-10

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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