Hospice Medicare Cost Report

 

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With 25 years of experience, Walters & Associates, CPAs has the expertise to accurately prepare and electronically file your Medicare cost report.  With a 100% national healthcare client base ranging from very small single owner operations to very large publicly traded companies, we have worked with many comparable entities to yours.  Don’t take our word for it, here what others are saying by clicking here.

 

What is a Medicare cost report?

The cost report is an annual report submitted by all institutional providers participating in the Medicare program. The report is submitted on prescribed forms, depending on the type of provider (for example, hospital, skilled nursing facility, etc.). The cost information and statistical data reported must be current, accurate and in sufficient detail to support an accurate determination of payments made for the services rendered. The cost report contains provider information such as facility characteristics, utilization data, and financial statement data. CMS maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS).  The Medicare Cost Report records each institution’s total costs and charges associated with providing services to all patients, the portion of those costs and charges allocated to Medicare patients, and the Medicare payments received.

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How to obtain your PS&R

The Provider Statistical & Reimbursement (PS&R) system, which accumulates statistical and payment data for Medicare providers has been redesigned, and PS&R reports are now available on the Centers for Medicare & Medicaid Services (CMS) website. Fiscal Intermediaries/Medicare Administrative Contractors (FIs/MACs) will no longer issue PS&R summary reports used in filing for cost reporting periods, as had been the case in prior years. Providers must register to access the redesigned PS&R system and receive their PS&R reports for filing the Medicare cost report.

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Medicare cost report due dates

Medicare cost reports are generally due five (5) months after a fiscal year end. For example, if your fiscal year end is December 31, your Medicare cost report would be due May 31. There are exceptions (ex. Change of Ownership).

 

Hospice CAP

The Hospice Cap is a lifetime limit for each hospice patient.  The individual beneficiary Cap is $28,404.99 for the 2017 Cap Year and $$27,820.75 for the 2016 Cap year.  The total Cap for each hospice is determined on an aggregate basis.  This means that all patients are combined for each Cap Year when comparing the total CAP.  So if one patient is over Cap and another is under, the Hospice may still be under the aggregate CAP.

CMS has aligned the CAP Year for both the inpatient CAP and the hospcie aggregate CAP with the federal fiscal years for FY 2017 and after. 

Hospice Aggregate Cap Timeframes for Counting Beneficiaries and Payments for the Alignment of the Cap Accounting Year with the Federal Fiscal Year

Cap year

Beneficiaries

Payments

Streamlined method

Patient-by-patient proportional method

Streamlined method

Patient-by-patient proportional method

2016

9/28/15-9/27/16

11/1/15-10/31/16

11/1/15-10/31/16

11/1/15-10/31/16

2017 (Transition Year)

9/28/16-9/30/17

11/1/16-9/30/17

11/1/16-9/30/17

11/1/16-9/30/17

2018 and later

10/1-9/30

10/1-9/30

10/1-9/30

10/1-9/30

 

Hospices that are over the CAP will see over payments that will resurface for years.  It will continue on all patients that are served in the CAP year are deceased.  That is why it is critical to monitor the CAP and have sound admission policies.