Read Microsoft PowerPoint - 2010_NYHFMA_25522010Update.ppt text version

Form CMS-2552-10

Don Fry, Director, KPMG LLP, Los Angeles, CA Don Fry, Director, KPMG LLP, Los Angeles, CA Joe Sellars, Director, KPMG LLP, Jacksonville, FL Joe Sellars, Director, KPMG LLP, Jacksonville, FL HFMA Educational Session HFMA Educational Session April, 2010 April, 2010

CMS-2552-10

Last major revision to the hospital cost report was in 1996. Timeline Notice of the new forms and instructions was published in the July 2, 2009 Federal Register. CMS is still reviewing comments, finalizing forms and instructions, and obtaining OMB approval. CMS current target date: Fiscal-Years Beginning May 1, 2010 and thereafter. Filing deadline for first wave of 12-month cost reports to be received by Medicare Administrative Contractors: September 30, 2011

2

CMS-2552-10

SUMMARY OF REVISIONS Standardize subscripted lines and renumber forms. Reorganize data on Worksheet S-2. Remove obsolete worksheets. Assign separate settlement worksheets for the following: 1. Inpatient Psychiatric Facility or subprovider. 2. Inpatient Rehabilitation Facility or subprovider. 3. Long Term Care Hospital.

3

CMS-2552-10

SUMMARY OF REVISIONS (continued)

Include Worksheet S-2, Part II to: 1. Incorporate data previously reported on FORM CMS-339. 2. Require electronic submission as part of the filing. 3. Eliminate separate submission of the FORM CMS-339. Include Worksheet S-3, Part IV to collect wage information previously reported on the FORM CMS-339. Include Worksheet S-3, Part V to collect contract labor and benefit costs. Redesign numerous worksheets for more efficient collection of data.

4

Worksheet S

5

Worksheet S-2

Lines 1 - 19 general provider information Lines 1 - 19 general provider information Lines 20 ­ 24 acute care PPS information Lines 20 ­ 24 acute care PPS information Lines 25 ­ 29 SCH/MDH information Lines 25 ­ 29 SCH/MDH information Lines 30 ­ 32 capital PPS information Lines 30 ­ 32 capital PPS information Lines 33 ­ 42 medical education information Lines 33 ­ 42 medical education information Lines 50 ­ 51 IPF PPS information Lines 50 ­ 51 IPF PPS information Lines 55 ­ 56 IRF PPS information Lines 55 ­ 56 IRF PPS information Line 60 ­ LTCH information Line 60 ­ LTCH information

6

Worksheet S-2

Lines 65 - 66 TEFRA provider information Lines 65 - 66 TEFRA provider information Lines 70 ­ 71 Title V and XIX information Lines 70 ­ 71 Title V and XIX information Lines 80 ­ 84 rural hospital information Lines 80 ­ 84 rural hospital information Lines 90 ­ 94 miscellaneous information Lines 90 ­ 94 miscellaneous information Lines 95 ­ 104 transplant center information Lines 95 ­ 104 transplant center information Lines 110 ­ 119 home office and "other" information Lines 110 ­ 119 home office and "other" information Lines 130 ­ 136 LCC exceptions Lines 130 ­ 136 LCC exceptions Lines 140 ­ 141 Multi-campus hospital information Lines 140 ­ 141 Multi-campus hospital information

7

Worksheet S-2 (continued)

8

Worksheet S-2 (continued)

9

Worksheet S-2, Part II

10

Worksheet S-2, Part II (continued)

11

Worksheet S-2, Part II (continued)

12

Worksheet S-2, Part II (continued)

13

Worksheet S-3, Part I

14

Worksheet S-3, Part I (continued)

15

Worksheet S-3, Part II

4090 (Cont.)

HOSPITAL WAGE INDEX INFORMATION

FORM CMS-2552-10

PROVIDER NO.: ______________ PERIOD: FROM __________ TO _____________ Adjusted Salaries (col. 2 ± col. 3) 4 Paid Hours Related to Salaries in col. 4 5

DRAFT

WORKSHEET S-3, PART II

PART II - WAGE DATA Worksheet A Line Number 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 SALARIES Total salaries (see instructions) Non-physician anesthetist Part A Non-physician anesthetist Part B Physician-Part A Physician-Part B Non-physician-Part B Interns & residents (in an approved program) Home office personnel SNF Excluded area salaries (see instructions) OTHER WAGES & RELATED COSTS Contract labor (see instructions) Management and administrative services Contract labor: physician-Part A Home office salaries & wage-related costs Home office: physician Part A Teaching physician salaries (see instructions) WAGE-RELATED COSTS Wage-related costs (core) Wkst S-3, Part IV line 24 Wage-related costs (other)Wkst S-3, Part IV line 25 Excluded areas Non-physician anesthetist Part A Non-physician anesthetist Part B Physician Part A Physician Part B Wage-related costs (RHC/FQHC) Interns & residents (in an approved program) Reclass. of Salaries (from Wkst. A-6) 3 Average Hourly Wage (col. 4 ÷ col. 5) 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Amount Reported 2

16

Worksheet S-3, Part II & III

DRAFT

HOSPITAL WAGE INDEX INFORMATION

FORM CMS-2552-10

PROVIDER NO.: ______________ PERIOD: FROM __________ TO _____________ Adjusted Salaries (col. 2 ± col. 3) 4 Paid Hours Related to Salaries in col. 4 5

4090 (Cont.)

WORKSHEET S-3, PART II & III

PART II - WAGE DATA Worksheet A Line Number 1 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 PART 1 2 3 4 5 6 7 OVERHEAD COSTS - DIRECT SALARIES Employee Benefits Administrative & General Administrative & General under contract (see inst.) Maintenance & Repairs Operation of Plant Laundry & Linen Service Housekeeping Housekeeping under contract (see instructions) Dietary Dietary under contract (see instructions) Cafeteria Maintenance of Personnel Nursing Administration Central Services and Supply Pharmacy Medical Records & Medical Records Library Social Service Other General Service III - HOSPITAL WAGE INDEX SUMMARY Net salaries (see instructions) Excluded area salaries (see instructions) Subtotal salaries (line 1 minus line 2) Subtotal other wages & related costs (see inst.) Subtotal wage-related costs (see inst.) Total (sum of lines 3 thru 5) Total overhead cost (see instructions Reclass. of Salaries (from Wkst. A-6) 3 Average Hourly Wage (col. 4 ÷ col. 5) 6 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43

Amount Reported 2

1 2 3 4 5 6 7

17

Worksheet S-3, Part IV

4090 (Cont.)

HOSPITAL WAGE RELATED COSTS

FORM CMS-2552-10

PROVIDER NO.: ______________ PERIOD: FROM __________ TO _____________

DRAFT

WORKSHEET S-3, PART IV

PART IV - Wage Related Cost Part A - Core List

Amount Reported RETIREMENT COST 401K Employer Contributions Tax Sheltered Annuity (TSA) Employer Contribution Qualified and Non-Qualified Pension Plan Cost Prior Year Pension Service Cost PLAN ADMINISTRATIVE COSTS (Paid to External Organization): 401K/TSA Plan Administration fees Legal/Accounting/Management Fees-Pension Plan Employee Managed Care Program Administration Fees HEALTH AND INSURANCE COST Health Insurance (Purchased or Self Funded) Prescription Drug Plan Dental, Hearing and Vision Plan Life Insurance (If employee is owner or beneficiary) Accidental Insurance (If employee is owner or beneficiary) Disability Insurance (If employee is owner or beneficiary) Long-Term Care Insurance (If employee is owner or beneficiary) Workers' Compensation Insurance Retirement Health Care Cost (Only current year, not the extraordinary accrual required by FASB 106. Non cumulative portion) TAXES FICA-Employers Portion Only Medicare Taxes - Employers Portion Only Unemployment Insurance State or Federal Unemployment Taxes OTHER Executive Deferred Compensation Day Care Cost and Allowances Tuition Reimbursement Total Wage Related cost (Sum of lines 1 -23)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

Part B Other than Core Related Cost 25 Other Wage Related Costs (specify)_________________________________________

25

18

Worksheet S-3, Part V

DRAFT FORM CMS-2552-10

PROVIDER NO.: ______________

4090 (Cont.)

PERIOD: WORKSHEET S-3, FROM __________ PART V TO _____________

HOSPITAL CONTRACT LABOR AND BENEFIT COST

PART V - Contract Labor and Benefit Cost

Hospital and Hospital-Based Component Identification: Component 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Hospital Subprovider- IPF Subprovider- IRF Subprovider- (Other) Swing Beds-SNF Swing Beds-NF Hospital-Based SNF Hospital-Based NF Hospital-Based OLTC Hospital-Based HHA Separately Certified ASC Hospital-Based Hospice Hospital-Based Health Clinic (RHC/FQHC) Hospital-Based-CMHC Renal Dialysis Component Name 1 Provider Number 2 Contract Labor 3 Benefit Cost 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

19

Worksheet S-7

20

Worksheet S-7 (continued)

21

Worksheet S-10

22

Worksheet S-10 (Continued)

23

Worksheet A

24

Worksheet A (continued)

25

Worksheet A-7, Parts I - II

26

Worksheet A-7, Part III

27

Worksheets A-8, A-8-1, A-8-2, A-8-3, A-8-4

Worksheet A-8 Worksheet A-8

Obsolete lines removed Obsolete lines removed Subscripts removed and lines renumbered Subscripts removed and lines renumbered

Worksheet A-8-1 Worksheet A-8-1

Section A lines remain 1-5 Section A lines remain 1-5 Section B lines renumbered from 1-5 to 6-10 Section B lines renumbered from 1-5 to 6-10

Worksheet A-8-2 Worksheet A-8-2

Total line changed from 101 to 200 Total line changed from 101 to 200

Worksheet A-8-3 Worksheet A-8-3

Deleted (obsolete) Deleted (obsolete)

Worksheet A-8-4 Worksheet A-8-4

Retained for CAH providers ­ renamed Worksheet A-8-3 Retained for CAH providers ­ renamed Worksheet A-8-3

28

Worksheet B Series

Worksheet B, Part III Worksheet B, Part III

Eliminated Eliminated

Worksheet B, Part II Worksheet B, Part II

All Capital combined All Capital combined

29

C and D Worksheets

Worksheet C, Part II eliminated Worksheet C, Part II eliminated Worksheet D, Part II and D, Part II eliminated old/new capital lines Worksheet D, Part and D, Part II eliminated old/new capital lines Worksheet D, Part III and IV, breakout of nursing school, allied health and Worksheet D, Part III and IV, breakout of nursing school, allied health and other medical education other medical education Worksheet D, Part V ­ Eliminated Part VI and added column for "not subject Worksheet D, Part V ­ Eliminated Part VI and added column for "not subject to deductibles and coinsurance". to deductibles and coinsurance". Worksheet D-1 ­ Minor changes Worksheet D-1 ­ Minor changes Worksheet D-2 ­ Minor changes Worksheet D-2 ­ Minor changes Worksheet D-4 ­ Renamed to Worksheet D-3 Worksheet D-4 ­ Renamed to Worksheet D-3 Worksheet D-6 ­ Renamed to Worksheet D-4 Worksheet D-6 ­ Renamed to Worksheet D-4 Worksheet D-9 ­ Renamed to Worksheet D-5 Worksheet D-9 ­ Renamed to Worksheet D-5

30

Worksheet D, Part V

31

E Worksheets

E, Part A ­ PPS Settlement Page E, Part A ­ PPS Settlement Page No Payment Splits No Payment Splits IME and 422 addition/reduction now on E, Part A IME and 422 addition/reduction now on E, Part A E Part B E Part B Outpatient PPS Outlier Calculation Outpatient PPS Outlier Calculation E-3 ­ Non-PPS Settlement Pages E-3 ­ Non-PPS Settlement Pages Part II - TEFRA Part - TEFRA Part II ­ IPF PPS Part II ­ IPF PPS Part III IRF PPS Part III IRF PPS Part IV LTCH PPS Part IV LTCH PPS Part V ­ Cost Part V ­ Cost Part VI - SNF PPS Part VI - SNF PPS Part VII ­ V and XIX Part VII ­ V and XIX E-4 Direct GME E-4 Direct GME

32

2552-10 FORMS AND INSTRUCTIONS ARE AVAILABLE VIA CMS WEB SITE

CMS web site URL: CMS web site URL:

http://www.cms.hhs.gov/PaperWorkReductionActof1995 http://www.cms.hhs.gov/PaperWorkReductionActof1995

Click on "PRA Listing" on the left side of the screen. Click on "PRA Listing" on the left side of the screen. Select form number CMS-2552-10 Select form number CMS-2552-10 Select zip file CMS-2552-10 to download. Select zip file CMS-2552-10 to download.

33

American Recovery and Reinvestment Act of 2009

One goal ­ Reduce long-term costs by modernizing One goal ­ Reduce long-term costs by modernizing healthcare through the use of information technology healthcare through the use of information technology Drive adoption of electronic health records by 2015 Drive adoption of electronic health records by 2015 $36 Billion in Medicare and Medicaid payments $36 Billion in Medicare and Medicaid payments Significant Medicare payment penalties for nonSignificant Medicare payment penalties for noncompliance compliance Requires that CMS provide incentive payments under Requires that CMS provide incentive payments under Medicare and Medicaid to "Meaningful Users" of Medicare and Medicaid to "Meaningful Users" of Electronic Health Records (EHR) Electronic Health Records (EHR)

34

American Recovery and Reinvestment Act of 2009

Government Expansion Federal ­ Office of the Government Expansion Federal ­ Office of the National Coordinator for Health IT (ONCHIT) National Coordinator for Health IT (ONCHIT) 2006 budget $8 million 2006 budget $8 million 2007/8 budget $61 million 2007/8 budget $61 million 2009 budget $2 billion 2009 budget $2 billion $300 million granted to states or "qualified" state$300 million granted to states or "qualified" statedesignated partnerships designated partnerships Funding will create IT employment Funding will create IT employment Will change the current health IT standardization from Will change the current health IT standardization from a voluntary effort to one in which standards are a voluntary effort to one in which standards are mandated. mandated.

35

American Recovery and Reinvestment Act of 2009

Incentive Payments will be made to: Incentive Payments will be made to: Eligible Professionals (EPs) ­ doctors Eligible Professionals (EPs) ­ doctors Subsection (d) Hospitals ­ all IPPS hospitals, excluding Subsection (d) Hospitals ­ all IPPS hospitals, excluding IRF, IPF, Children, Cancer, etc. (Approx. 3,600 total) IRF, IPF, Children, Cancer, etc. (Approx. 3,600 total) Critical Access Hospitals ­ about 1,300 total Critical Access Hospitals ­ about 1,300 total

36

American Recovery and Reinvestment Act of 2009

Hospitals may receive one consolidated payment or Hospitals may receive one consolidated payment or multiple payments during the year (Secretary multiple payments during the year (Secretary discretion). discretion). If Hospital is deemed a "Meaningful User" during a If Hospital is deemed a "Meaningful User" during a "Reporting Period", they are eligible to receive the "Reporting Period", they are eligible to receive the payment. payment. First year for hospital payments is FY 2011 First year for hospital payments is FY 2011 Payments may be made for multiple years (100% for Payments may be made for multiple years (100% for the first and then decreasing amounts) the first and then decreasing amounts) If hospital doesn't become a "Meaningful User" they If hospital doesn't become a "Meaningful User" they will eventually be penalized. will eventually be penalized.

37

American Recovery and Reinvestment Act of 2009

If "Meaningful User" ­ eligible to receive $2M Base If "Meaningful User" ­ eligible to receive $2M Base Amount plus a Total Discharge Add-on, multiplied by Amount plus a Total Discharge Add-on, multiplied by the Medicare Share the Medicare Share Total discharge add-on Total discharge add-on $200 per discharge $200 per discharge Discharges over 1,150 and under 23,000 Discharges over 1,150 and under 23,000 Medicare Share: Medicare Share: Numerator = IP Days Part A + Part C Numerator = IP Days Part A + Part C Denominator = Total Days x ((Eligible Charges ­ Denominator = Total Days x ((Eligible Charges ­ Charges Attributable to Charity Care)/Eligible Charges Attributable to Charity Care)/Eligible Charges)) Charges))

38

American Recovery and Reinvestment Act of 2009

Year hospital first becomes meaningful HER user Year hospital first becomes meaningful HER user FY 2011, 2012 or 2013 FY 2011, 2012 or 2013 First year of transition First year of transition Second year of transition Second year of transition Third year of transition Third year of transition Fourth year of transition Fourth year of transition Any succeeding year of transition Any succeeding year of transition 2014 2014 2015 2015

100% 100% 75% 75% 50% 50% 25% 25% -0 -0-

75% 75% 50% 50% 25% 25% -0 -0-0 -0-

50% 50% 25% 25% -0 -0-0 -0-0 -0-

Beginning in 2015 covered hospitals and CAHs who are not meaningful EHR users will have their Medicare payments reduced.

39

American Recovery and Reinvestment Act of 2009

FI/MAC Implications (per CR 6687) FI/MAC Implications (per CR 6687) Contractors will need to calculate the Payment Amount Contractors will need to calculate the Payment Amount using the complex formula. using the complex formula. Contractors will need to make the payment Contractors will need to make the payment The amount will be re-calculated on the cost report and The amount will be re-calculated on the cost report and will be "reconciled" as part of the NPR will be "reconciled" as part of the NPR CMS is currently working to determine the processes. CMS is currently working to determine the processes. Proposed Regulation mid. 2010. Proposed Regulation mid. 2010. Transmittal to 2552-10 to accommodate payment. Transmittal to 2552-10 to accommodate payment.

40

American Recovery and Reinvestment Act of 2009

CAH Implications CAH Implications If CAH is a "Meaningful User" they will receive the If CAH is a "Meaningful User" they will receive the Costs of the HIT * the Medicare Share Costs of the HIT * the Medicare Share Costs of the HIT = costs to purchase the technology Costs of the HIT = costs to purchase the technology (depreciable base). Can be expensed in one year. (depreciable base). Can be expensed in one year. Medicare Share = same as hospital + 20 percentage Medicare Share = same as hospital + 20 percentage points (cannot exceed 100%) points (cannot exceed 100%) "Prompt Payment" will be made after submission of "Prompt Payment" will be made after submission of supporting documentation (subject to reconciliation). supporting documentation (subject to reconciliation). CAH will eventually be penalized if not a user CAH will eventually be penalized if not a user

41

Questions?

42

Information

Microsoft PowerPoint - 2010_NYHFMA_25522010Update.ppt

42 pages

Report File (DMCA)

Our content is added by our users. We aim to remove reported files within 1 working day. Please use this link to notify us:

Report this file as copyright or inappropriate

207013