INSIGHTS FOR HEALTH CARE 

JUNE 28, 2016   
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Medicare Mentor
 
Due to the complexity and continuous flow of releases by CMS, we will be providing special editions to our eNewsletter. The "Medicare Mentor" will highlight important updates regarding Medicare reimbursement and your Medicare cost report--what they mean to you and how we recommend you respond.
 
Medicare Cost Report S-10 Data: Uncompensated Care
The Centers for Medicare and Medicaid Services (CMS) recently issued the 2017 Inpatient PPS proposed rule. This proposal includes language indicating for Federal fiscal year (FFY) 2018 there will be a transition to the use of Worksheet S-10 for Factor 3 in the Uncompensated Care Calculation.
 
Since the passage of the Affordable Care Act, hospitals have been receiving a share of a decreasing pool of Uncompensated Care dollars. The distribution of these dollars has been determined using a hospital's supplemental security income (SSI) fraction and Medicaid fraction.
 
CMS had originally intended to use Worksheet S-10 data to calculate Factor 3 but had not done so due to concerns about the accuracy of the data. CMS is now of the belief that, as of FFY 2014, hospitals were or should be aware of the intent that this data will be used for the calculation and has proposed to start using the data.
 
Beginning in FFY 2018 and in subsequent years, Factor 3 will be a three-year average. There will be a transition period when Medicaid days will still be used. In 2018, Factor 3 will be the average of:
  1. Factor 3 calculated with 2012 cost report Medicaid days and the 2014 SSI ratio;
  2. Factor 3 using 2013 cost report Medicaid days and the 2015 SSI ratio; and
  3. Factor 3 based on 2014 cost report Worksheet S-10 data.
In 2019, the cost report S-10 data will be used to calculate two of the three factors. As of 2020, Worksheet S-10 will be used for all three years (FFY 2014, 2015, and 2016).*
 
Read the full article here.

Medicare PS&R Access
We frequently encounter facilities that cannot access their PS&Rs from CMS. If you are having any issues with obtaining your Medicare PS&R report within the EIDM system, CMS has established an External User Services (EUS) Help Desk to assist with your access to EIDM.
 
Read the full article here.

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