Southwest Consulting Associates Blog

On April 28, 2017, CMS published the FFY 2018 IPPS Proposed Rule in the Federal Register.  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 have finally moved forward with implementation.  Go HERE for our summary of the Medicare DSH/Uncompensated care payment portion of the proposed rule.  In this post, we will take a dive into Factor 2 as described in the proposed rule.  For a quick refresher on Factor 2, go HERE.

Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, S-10, regulations, proposed rule, worksheet s-10, factor 2

On April 28, 2017, CMS published the FFY 2018 IPPS Proposed Rule in the Federal Register.  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 have finally moved forward with implementation.  Go HERE for our high-level summary of the Medicare DSH/Uncompensated care payment portion of the proposed rule.  In this post, we will take a dive into Factor 1 as described in the proposed rule.  For a quick refresher on Factor 1, go HERE.

Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, 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

 

Topics: DSH Reimbursement, Medicare DSH Reimbursement, DSH Litigation Environment, PRRB decisions

In anticipation that CMS might finalize the DSH/UC payment methodology proposed in the 2017 IPPS proposed rule, CMS released Change Request 9648, Transmittal 1681 (please see page 3, paragraph 2) in July, which included, among other items, guidance for MACs to follow for accepting cost reports containing revised Worksheet S-10 information. Specifically, in order for MACs to accept amended cost reports due to revisions to Worksheet S-10 for FY 2014, CMS 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, 2016.” CMS added, “Submissions received on or after October 1, 2016 will not be accepted.”

Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, S-10

The 2017 IPPS Final Rule was posted on August 2, 2016 and will be effective October 1, 2016.  Below is SCA’s summary on the rule as it affects disproportionate share hospitals (DSH).  

 

Quick Review of the DSH Payment Under ACA

As a result of the ACA, the amount of total DSH reimbursement a provider may receive for discharges beginning October 1, 2013, is now based upon two components:

Topics: Medicare DSH Reimbursement, uncompensated care, S-10, regulations, final rule

On August 2, 2016, CMS posted the 2017 IPPS final rule. While we will provide a comprehensive summary of the rule in the near future, this post relates to the changes that CMS is making regarding Medicare DSH reimbursement and the use of cost report worksheet S-10 to calculate factor 3 for federal fiscal years 2018-2021. As you recall, in the 2017 proposed rule, CMS indicated that it would begin using S-10 to calculate factor 3, at least in part, beginning in FFY 2018. However, in the final rule CMS states: 

Topics: DSH Reimbursement, Medicare DSH Reimbursement, uncompensated care, S-10, regulations, final rule

On July 15, 2016, CMS posted the FFY 2014 SSI ratios to their website.  The FFY 2014 SSI ratios should be used for computing the Disproportionate Share Hospital payment for cost reporting periods beginning on or after October 1, 2013, and before October 1, 2014.  The FFY 2014 SSI ratio file (DSH Adjustment and 2013-2014 File [ZIP, 270KB]) can be found in the Downloads section of CMS' Disproportionate Share Hospital (DSH) webpage or by following the link below:

Topics: Medicare DSH Reimbursement

The 2017 IPPS Proposed Rule was put on display for public inspection on April 18, 2016 and is scheduled to be published in the Federal Register on Wednesday, April 27, 2016.  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 June 17, 2016.  Below is SCA’s brief, yet comprehensive summary on the proposed rule as it will affect DSH hospitals.

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