Southwest Consulting Associates Blog

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.

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

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.

 

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

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?  

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

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?  

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

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

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

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