报销咨询

2023年11月更新

CMS issued a Transmittal 18 on December 29, 2022, for the hospital cost reporting Form 2552-10. Several changes were made in this transmittal, but what affects almost all hospital providers are the updated Medicare Bad Debt (表现出2) and S-10 (Exhibits 3b and 3c) exhibits below which were made a requirement in this transmittal. These exhibits are required for cost reporting periods ending on or after September 30, 2023.

• 表现出2 – Medicare bad debt log for cost report periods beginning Oct 1, 2022 and after
• 展览3 b – S-10 log for charity care charges
• 展览3 c – S-10 log for total facility bad debts

More detail of Transmittal 18: http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Transmittals/r18p240i

LBMC is prepared to assist all providers regulated by this transmittal and to assist in the preparation of these exhibits.

2023年1月发布

What affects almost all hospital providers are the updated exhibits below which were made a requirement in this transmittal. This transmittal affects providers for cost reporting periods beginning on or after October 1, 2022.

• 展示1 – Allocation of Physician Compensation
• 附表2 – Medicare bad debt log for cost report periods beginning prior to Oct 1, 2022.
• 表现出2 – Medicare bad debt log for cost report periods beginning Oct 1, 2022 and after
• 展览3 – Medicaid eligible days for a DSH eligible hospital
• 展览3 b – S-10 log for charity care charges
• 展览3 c – S-10 log for total facility bad debts

The 2023 appropriations bill provides for funding levels for several rural health programs.  It was signed by President Biden December 29, 2022.

$5 million was designated in this bill to establish an Office of Rural Health at Centers for Disease Control and Prevention (CDC). This Office of Rural Health at the CDC will enhance implementation of CDC’s rural health portfolio, coordinate efforts across CDC programs and develop strategic plan for rural health.

该法案还支持 乡村医院 and core rural health care programs, as listed below:

农村医院项目

• $3.450亿美元 Rural Community Facilities Program 还有200万美元 Rural Hospital Technical Assistance Program through the United 状态s Department of Agriculture Rural Development (RD) programs.
• $64.300万美元 Medicare Rural Hospital Flexibility Grants Program (an increase of more than $2 million over FY 2022 funding levels). 64美元的.3 million includes $21 million for the Small Rural Hospital Improvement Grant Program and $5 million to continue funding the Rural Emergency Hospital (REH) TA Program.

Continuation of Core Rural Health Care Programs

• $12.5 million for 状态 Offices of Rural Health (level funding)
• $145 million for the Rural Communities Opioids Response Program ($10 million increase)
• $12.5 million for the Rural Residency Development Program ($2 million increase)
• $125 million for the National Health Service Corps ($3 million increase)
• $8 million for the Rural Maternity and Obstetrics Management Strategies (RMOMS) Program at HRSA ($2 million increase)

Statutory Pay-As-You-Go Act (PAYGO) of 2010

The Statutory Pay-As-You-Go Act (PAYGO) of 2010 required a mandatory spending and revenue legislation to not increase the federal budget deficit.  The PAYGO sequester was waived through 12/31/22 with the passage of the American Rescue Plan Act.  PAYGO sequester is now deferred until January 2025, which avoids a 4% cut to Medicare reimbursement.

远程医疗

远程医疗 flexibilities will now continue until December 31, 2024. In the FY 2022 omnibus appropriations bill extended telehealth flexibilities for 151 days post-PHE. The bill extends these critical PHE provisions, including audio-only flexibilities through December 31, 2024.

医疗保险支付

• Low-Volume Hospital (LVH) and Medicare-Dependent Hospital (MDH) designation both extended through September 30, 2024.
• Ground Ambulance add-on payments extended for two years through December 31, 2024.
• 医生附加付款 for services furnished in calendar year 2023, the add-on payment will be 2.医生占5%. For services furnished in calendar year 2024, the add-on payment will be 1.25%.
• Home health rural add-on payment at one percent through the end of 2023.

精神健康条文

• Coverage of Marriage and Family Therapists (MFT) and mental health counselors (MHC) under Medicare.
• Inclusion of 200 new residency slots for psychiatry or psychiatry subspecialties. 2026财年, the Secretary shall begin distribution of these slots, with a minimum of 10 percent going toward hospitals located in rural areas.
• Inclusion of the Restoring Hope for Mental Health and Well-Being Act

Here is the link to the American Hospital Association notice regarding this $1.7万亿美元的综合法案.  http://www.aha.org/news/headline/2022-12-30-biden-signs-17-trillion-omnibus-appropriations-bill

成本报告服务

• Preparation and/or review of Medicare and/or Medicaid Cost Reports.
• Review and assistance with tentative settlements, 成本报告审计, appeals and other correspondence with CMS and MACs.
• Review of previously filed cost reports in order to identify potential exposure and reimbursement opportunities.
• Compilations or independent review of various Medicaid and other 状态 Program Reports such as Residential Treatment Centers.

Payor Contracting and Negotiations

• Chargemaster评论
• Review all current contracts for compliance, performance and renegotiate with payors, 适当的, to obtain more favorable contract conditions and/or rates.
• Review all new contract proposals and recommend acceptance or denial, based on potential performance and fit with the group’s strategy and goals.
• Review payor market shares in your area and new contract recommendations.
• Provide telephone and email support to your staff on questions related to payor contracts.
• Provide ongoing monitoring of contracts for payor compliance.
• Project environments: Hospitals, ASC, 康复中心, Psych (inpatient and outpatient), Physicians (hospital and non-hospital based) and Ancillary services.

咨询服务

• Identify and assist with opportunities for Disproportionate Share (DSH) and Low Income (LIP) reimbursement for medical/surgical and rehabilitation hospitals, 分别.
• Assist in compiling and/or review of traditional Medicare Bad Debts and Medicaid “crossover” Bad Debts.
• Square Footage Analysis for proper cost allocations.

其他发还款项服务

• Assist with Wage Index audits and review for potential Geographic reclassifications.
• Consultations for various Provider based issues.
• Assistance with completion and filing of occupational mix surveys.
• Due diligence to assist with opportunities and liabilities with acquisition/merger activities.