CMS updates Medicare cost report for hospitals

CMS has made several changes to the Medicare cost report for hospitals that include uncompensated care, Medicare disproportionate share hospital, bad debt and graduate medical education, according to legal news website JDSupra.

Transmittal 18, which CMS posted to its website Dec. 29, is likely to significantly affect hospital reimbursement for providers that are unprepared. The changes took effect for cost reporting periods beginning Oct. 1, 2022. 

Four takeaways:

1. CMS has created another S-10 Worksheet. Part I aims to capture the entire hospital complex uncompensated care while Part II aims to capture hospital-only data, according to the report. CMS is considering using Part II data to calculate uncompensated care payments to hospitals in the future. 

2. The agency adjusted the instructions for reporting Medicaid eligible patient days on Worksheet S-2.  Hospitals can now report patient days of patients regarded as eligible for Medicaid under a waiver authorized as part of the Social Security Act. 

3. CMS updated the instructions for determining direct graduate medical education payments on Workshee E-4. The instructions implement the revised DGME payment methodology that CMS adopted in the 2023 inpatient prospective payment rule and eliminate penalties for hospitals that train residents and fellows and operate over their full-time equivalent caps, according to the report.

4. The agency also added four exhibits that hospitals must submit with the cost report, including data to support Medicaid eligible days, Medicare bad debt, total bad debt and charity care.

Click here to access the new cost report and here for the revised instructions.

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