Amended Cost Reports or S-10 Revisions - JE Part A
Amended Cost Reports or S-10 Revisions
Medicare's Cost Report Worksheet S-10 to Capture Uncompensated Care Data Updates
For Inpatient Prospective Payment System (IPPS) hospitals, CMS has granted an extension from September 30, 2017 until October 31, 2017 for all IPPS hospitals to resubmit certain Worksheet S-10 data. As described in the FY 2018 IPPS/Long-Term Care Hospital Prospective Payment System (LTCH PPS) final rule (82 FR 38208, August 14, 2017), the initial deadline had been September 30, 2017.
For revisions to be considered, CMS is modifying the deadline such that amended FY 2014 and FY 2015 cost reports due to revised or initial submissions of Worksheet S-10 must be received by Medicare Administrative Contractors (MACs) on/before October 31, 2017.
This instruction applies only to Worksheet S-10 of the FY 2014 and FY 2015 cost reports for IPPS hospitals. Revisions to Worksheet S-10 from other fiscal years, revisions to other worksheets of the FY 2014 and FY 2015 cost reports, or revisions to Worksheet S-10 by non-IPPS hospitals are not subject to this instruction.
Cost Report Worksheet S-10 Revisions
Amending Cost Reports or Requesting Reopenings for Cost Reports to Revise Worksheet S-10 (Hospital Uncompensated and Indigent Care Data)
Provider Types Affected: Inpatient Prospective Payment System (IPPS) hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCHs) submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.
Cost Reporting Periods Affected: Cost reporting periods beginning during Fiscal Year (FY) 2014 (cost reporting periods beginning on or after 10/01/13, and before 10/1/14), except when explicitly directed by CMS.
Amended Cost Reports: Providers may amend cost reports that have not been final settled to revise worksheet S-10 to ensure S-10 data is accurate for potential use by CMS in determining fiscal year 2018 uncompensated care payments. For revisions to be considered, hospitals must submit their amended cost report containing the revised Worksheet S-10 (or a completed Worksheet S-10 if no data had been included on the previously submitted cost report) no later than 9/30/16. Submissions received on or after 10/1/16 will not be accepted. This instruction only applies to Worksheet S-10 of FY 2014 cost reports for IPPS hospitals, revisions to Worksheet S-10 from other fiscal years, revisions to other worksheets of the FY 2014 cost reports, or revisions to Worksheet S-10 by non-IPPS hospitals are not subject to this instruction.
Cost Report Reopening Requests: For cost reports beginning in FY14 that have been final settled, providers may request a reopening to revise worksheet S-10 to ensure S-10 data is accurate for potential use by CMS in determining fiscal year 2018 uncompensated care payments. For revisions to be considered, hospitals must submit their reopening request and supporting documentation containing the revised Worksheet S-10 (or a completed Worksheet S-10 if no data had been included on the previously submitted cost report) no later than 9/30/16. Submissions received on or after 10/1/16 will not be accepted.
Amended Cost Reports
The Provider Reimbursement Manual, Part 1 (PRM-1), Chapter 29, Section 2931.2 provides requirements for amending Medicare cost reports.
Ordinarily, a cost report filed in a manner consistent with regulations and policy governing its preparation is intended to be final when settlement has been made or following an audit when determined to be necessary by the contractor. However, a cost report may also be considered final when initially delivered to the contractor although the contractor may not have performed its desk review and, if necessary, its audit. Under limited circumstances Noridian may accept an amended cost report submitted by a provider in order to:
- correct material errors detected subsequent to the filing of the original cost report.
- comply with health insurance policies or regulations or,
- reflect the settlement of a contested liability.
An amended cost report will not be accepted if:
- submitted after the desk review start date unless Noridian determines that it is in the best interest of the program. Please contact Noridian if you are not sure whether we have started a desk review or if you have other questions about re-filing the report.
- the protested amounts differ in any way from the amounts previously reported on the initial cost report submission. The Provider Reimbursement Manual, Part 2 (PRM-2), Chapter 1, Section 115, provides requirements for reporting protested amounts. Protested amounts are only allowed in the initial cost report submission.
All necessary corrections should be included in one amended cost report. As a general rule, Noridian will not accept a second amended report filed for the same cost report year.
When submitting an amended cost report, please include:
- a letter stating what is being amended, the reason for the change and the reimbursement effect.
- adequate supporting documentation.
- a signed Worksheet S certification page. We recommend using a color other than black for the signature to avoid doubt that it is an original signature and not a photocopy.
- electronic EC/PI files that pass all level 1 edits.
- if the S-10 audit has been completed, you must include the S-10 Adjustments. This is applicable only for PPS hospitals.
- if the Wage Index Desk Review has been completed, you must include the Wage Index Adjustments. This is applicable only for PPS hospitals.
If this information is not included, the amended cost report will not be accepted and will be returned to the provider.
Matters relating to cost report reopenings and/or amended cost reports should be referred to the audit manager as listed on the Contact Noridian Management webpage.
