Interns and Residents - JE Part A
Interns and Residents Information System (IRIS)
Per PRM II, Sec 140, when submitting the cost report, teaching facilities must include a diskette with their Intern and Resident information that will pass all IRIS system edits.
The Medicare Administrative Contractor (MAC) (Noridian) has 30 days from the date of receipt of the providers cost report to make a determination of acceptability. If the submitted cost report is considered unacceptable, the MAC will return the cost report to the provider with a letter explaining the reasons for rejection. If the due date for the cost report has expired, the MAC will begin withholding of interim payments and/or assessment of interest and penalties and issue a demand letter as soon as possible but no later than 30 days after the due date of the cost report.
If the primary reason for the rejection of the cost report is a "bad" or "damaged" diskette, the MAC will return the "bad" or "damaged" diskette with the instruction that a good diskette must be resubmitted within 15 days from the date of the rejection notice letter.
If the primary reason for the rejection of the cost report is that the IRIS diskette being processed contains errors, Noridian is to issue a rejection notice and give the provider 30 days from the date of the rejection notice to correct the errors and resubmit to the fiscal intermediary.
If a good diskette is not received within the stated grace period as required by the rejection letter, Noridian is to reject the entire cost report package and begin withholding of interim payments.
The following situations concerning the IRIS disk can cause rejection of the cost report:
- The provider failed to submit the IRIS diskette.
- The provider has submitted the required IRIS diskette, but:
- it contains an old version of IRIS (e.g. IRIS 95);
- it contains the wrong files (e.g. IRIS data for previous cost report period);
- the FI is unable to open or process the electronic file (e.g., IRIS master file has fiscal year begin date later than the fiscal year end date);
- the diskette contains unintellegible data;
- the diskette is unreadable; or
- the diskette is damaged.
- The files do not match the IRIS .dbf file naming convention. Filename Convention: M######_YYYY-MM-DD.dbf and A######_YYYY-MM-DD.dbf.
Approved XML IRIS Vendors
The federal register for fiscal year 2022 updated 42 CFR 413.24(f)(5)(i)(A) to require that teaching providers file their IRIS data using the XML format for all cost reports with fiscal year beginning on or after October 1, 2021. Below is a list of software vendors who have submitted sample XML IRIS files to CMS that have been confirmed to meet the requirements of the new XML IRIS file format. Providers are not required to use vendors from this list.
- Besler - iRotations
- Health Financial Systems - HFSSoft IRIS
- MyEvaluations.com - MyGME
- New Innovations
Intern and Resident Information System (IRIS) Edit Programs
Two IRIS software programs are available for teaching hospital and provider community use: IRISV3 and IRISEDV3. These programs are used by teaching hospitals and providers for collecting and reporting information on resident training in hospital and non-hospital settings.
The use of this software is limited to "non-commercial" applications; these applications may not be used for purposes of sales, product line, endorsement or profit. Users may copy and distribute them as long as they are not sold or modified in any way for profit.
This data entry/import program is used by providers to create an IRIS diskette/CD with two files (master and assignment) in dBASE file format. Providers have a choice of keying in resident data or importing master and assignment files that were created outside of the IRISV3 program or were previously created by IRISV3. An IRIS diskette/CD is created for each provider cost reporting period and a copy of the IRIS diskette/CD that has passed all edits in the IRISEDV3 program is mailed to the provider's servicing FI at the same time the provider's Medicare cost report is due.
This "edit only" program is used by providers and their servicing MACs to ensure that files on IRIS diskettes/CDs (those produced by IRISV3 or those created with outside software) pass all IRIS system edits. Errors that are revealed by IRISEDV3 for inaccurate or incomplete resident data cannot be corrected in IRISEDV3. Providers have the sole responsibility for correcting these errors in the IRIS diskette/CD files and these errors must be corrected outside of the IRISEDV3 program.
Providers are to run this program again on these corrected files to ensure that their IRIS diskettes/CDs pass all IRIS system edits. MACs likewise are to use IRISEDV3 on their copies of IRIS diskettes/CDs from providers to also ensure that these diskettes/CDs pass all IRIS system edits.
To download the IRIS programs and "Read Me" files, visit the CMS IRIS Software Programs webpage.
While CMS makes every effort to maintain the integrity of this software, CMS cannot guarantee the accuracy or completeness of data used by teaching hospitals and provider community for representing the output of this software.
Additional Intern and Resident Information System (IRIS) Codes
Updates to IRIS Software:
The IRIS software programs (IRISV3 and IRISEDV3) each have three updated files (medical school codes, residency type codes, and IRISV3 Operating Instructions) for collecting and reporting information on resident training in hospital and non-hospital settings. They are categorized as follows:
October 2015 IRISV3 Operating Instructions and Excerpts from IRISV3 Operating Instructions to Use with IRISEDV3:
- CMS added sixteen new IRIS residency type codes to the IRIS Residency Type Code Table.
- CMS also added four new IRIS medical school codes to the IRIS Medical School Code Table.
The IRIS programs are available for downloading via the IRIS website.
Last Updated Fri, 16 Dec 2022 21:19:54 +0000