Date: June 8, 2018
To: All IPPS Hospitals
From: Jeff Iwen, Director
Subject: Re-posting of the Preliminary Federal Fiscal Year (FY) 2020 Wage Index Public Use Files (PUF)

On Friday, May 18, 2018, CMS released the preliminary FY 2020 Worksheet S-3, Parts II and III wage index PUF. The FY 2020 IPPS wage index will be calculated based on Federal FY 2016 hospital cost reports; that is, cost reports with fiscal year begin (FYB) dates of on or after October 1, 2015 and on or before September 30, 2016. The PUF is available at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Wage-Index-Files-Items/FY2020-Wage-Index-Home-Page. 

This letter informs you that on June 5, 2018, CMS reposted the FY 2020 preliminary Worksheets S-3, Parts II and III and CY 2016 Occupational Mix Survey Data Public Use Files (PUFs) that were posted on CMS's website on May 18, 2018. This PUF is being reposted to include missing variables from Worksheets S-3, Parts II and IV that are first effective for cost reporting periods beginning on or after October 1, 2015.

Inclusion of New Line Items Effective for Cost Reporting Periods Beginning On or After October 1, 2015

Worksheet S-3, Part II and Worksheet S-3, Part IV include new line items that are first effective for cost reporting periods beginning on or after October 1, 2015, which is the cost reporting year to be used for the FY 2020 IPPS wage index. CMS inadvertently did not include these new line items when creating the FY 2020 preliminary PUF posted on May 18, 2018. Therefore, CMS has reposted the PUF to include these new line items.

You are required to ensure that you have accurately reported costs in these new line items if applicable to your hospital. These new line items are:

Worksheet S-3, Part II:

Line 14--For cost reporting periods beginning before October 1, 2015, enter the salaries and wage-related costs (as defined on lines 17 and 18) paid to personnel who are affiliated with a home office and/or related organization, who provide services to the hospital, and whose salaries are not included on Worksheet A, column 1. . . . For cost reporting periods beginning on or after October 1, 2015, do not use this line but use lines 14.01 and/or 14.02.

Line 14.01--For cost reporting periods beginning on or after October 1, 2015, enter the salaries paid to personnel affiliated with a home office, who provide services to the hospital, and whose salaries are not included on Worksheet A, column 1, but are included in Worksheet A, column 2, column 4 (if reported on Worksheet A-6), and/or column 6 (if reported on Worksheet A-8-1) . . . Report only home office salary costs on this line; report home office wage-related costs on line 25.50.

Line 14.02--For cost reporting periods beginning on or after October 1, 2015, enter the salaries paid to personnel affiliated with a related organization (other than home office), who provide services to the hospital, and whose salaries are not included on Worksheet A, column 1, but are included in Worksheet A, column 2, column 4 (if reported on Worksheet A-6), and/or column 6 (if reported on Worksheet A-8-1). . . Report only related organization salary costs on this line; report related organization wage-related costs on line 25.51.

Line 25.50--For cost reporting periods beginning on or after October 1, 2015, enter the core wage-related costs (as defined on line 17) paid to personnel who are affiliated with a home office whose salaries are reported on line 14.01.

Line 25.51--For cost reporting periods beginning on or after October 1, 2015, enter the core wage-related costs (as defined on line 17) paid to personnel who are affiliated with a related organization (other than home office) whose salaries are reported on line 14.02.

Line 25.52--For cost reporting periods beginning on or after October 1, 2015, enter the core wage-related costs (as defined on line 17) for Part A physician services - administrative, excluding teaching physicians Part A services, from the home office allocation and/or related organizations, whose salaries are reported on line 15.

Line 25.53--For cost reporting periods beginning on or after October 1, 2015, enter the core wage-related costs (as defined on line 17) for teaching physicians Part A services from the home office allocation and/or related organizations, whose salaries are reported on line 16.

Worksheet S-3, Part IV:

Lines 8, 8.01, 8.02, and 8.03--Effective for cost reporting periods beginning prior to October 1, 2015, complete line 8 if the hospital has purchased or self-funded insurance. Effective for cost reporting periods beginning on or after October 1, 2015, complete line 8.01 if the hospital has self-funded insurance without a TPA. Complete line 8.02 if the hospital has self-funded insurance with a TPA. Complete line 8.03 if the hospital purchases health insurance. (See the instructions under Worksheet S-3, Part II, regarding health insurance as a wage-related cost for the wage index).

Note on CY 2016 Occupational Mix Survey Data – No changes are being made to the Occupational Mix data posted in the May 18, 2018 PUF; a duplicate has been reposted as part of the reposting of the FY 2020 preliminary PUF.

Hospitals must review the FY 2020 preliminary file to confirm the inclusion and accuracy of their wage index and occupational mix data, related to both the previously existing and newly added line items effective for October 1, 2015.  All requests from hospitals for changes to their FY 2020 wage index data must be submitted to and received by their Medicare Administrative Contractors (MACs) by September 4, 2018. A hospital that wishes to revise its wage index and/or occupational mix data must submit its request along with complete, appropriate, detailed supporting documentation to its MAC. Requests postmarked by the September 4, 2018 deadline, but not received until after the deadline, will not be accepted. MACs must receive the revision requests and supporting documentation by this date.

If you have any questions, contact Barb Miers at 651-994-3907 or Barbara.Miers@noridian.com.