Cost Report Reconciliation FY11
After the close of each fiscal year, MassHealth will reconcile any interim payments made to the School-Based Medicaid provider to the actual, incurred Medicaid-allowable costs/expenditures that the provider has certified using the Massachusetts School-Based Medicaid Cost Report. To do this, the certified costs on the Cost Report are compared to the School-Based Medicaid provider's Medicaid interim rate claims for services delivered during the reporting period, as documented in NewMMIS.
Each School-Based Medicaid Provider's interim rate claims are adjusted to reflect, in the aggregate, the total Medicaid-allowable costs based on the certified Cost Report. If the Commonwealth determines that an underpayment has been made, the difference between the value of the interim payment and the value of the certified costs on the Cost Report will be paid to the School-Based Medicaid provider. If the Commonwealth determines that an overpayment has been made, EOHHS will recoup the amount of the overpayment from the School-Based Medicaid provider.
What will MSB need from you?
1. Salary and benefit data by quarter for FY11
If you have submitted all four quarters of AAC claiming and if no changes or corrections apply, your Job Code 1 salary and benefit data will be prepopulated for the cost report upload and no further action is required. If you did not file AAC claims, you will need to provide salary and benefit data by quarter and we will be happy to provide a template for you.
2. School District
Enrollment Information for students with an IEP as of January 5th 2011
Again, if you submitted an FY11 AAC Q3 claim, we already have this data. If not, it will be a requirement for the cost report.
3. Tuition payments FY11
Please provide a list of tuition payments for FY11 totaled by facility. Although tuition expenditures are reported on quarterly AAC claims, they are not itemized by code number. Cost reporting does require the totals by facility and code. Please click here to go to our website where you will find the "Out of District Program List" spreadsheet regarding allowable facilities and their code numbers under the Administrative section.
4. Other Direct Medical Costs FY11
Please provide a list of other direct medical costs include medical supplies, materials, purchased services, equipment and other costs. These costs must be consistent with OMB Circular A-87 and should only include costs that are 100% attributable to direct medical services. Exclude any costs that are part of the unrestricted indirect cost rate set by DESE. Exclude any portion of the costs that are funded by federal grants or are a required state or local match on federal grants.
Materials and supplies are allowable if used exclusively for the delivery of health care services. Consult Appendix A (Cost Report Supply List) for a list of materials and supplies that may qualify. Only materials and supplies used in Medicaid covered services for which the School-Based Medicaid Provider is including personnel costs can be included.
NOTE: Any item with a cost in excess of $5,000 and a useful life of at least one year will be treated as a capital expense, and should not be included in the cost report.
Cost report documentation (above) is due to MSB no later than November 23rd, 2011.
