Category Archive for: ‘Cost Report Information’

  • The Importance of Medicare Cost Report Compliance

    We know that CMS requires the Medicare Cost Report as a condition of payment, but we should also note the basic principle of Medicare Cost Report filing. See 42 C.F.R. s. 413.24. The overarching principle reads: “Providers receiving payment on the basis of reimbursable cost …

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  • CMS Final Rule 2014

    FY Final Rule for 2014 has been release here: Looks like there are changes to the wage index, GME, IME, and more implementation of the ACA. Updates wll follow soon.

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  • Medicare Cost Report and Electronic Health Records (EHR)

    The Medicare cost report has gain increasing importance as a result of Electronic Health Records (EHR) incentive payments. There are a number of EHR calculators that will help you determine your Medicare reimbursement, but I want to discuss the data elements needed to calculate the …

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  • Direct Graduate Medical Education (GME) – Part 1

    The purpose of this post is to discuss direct graduate medical education (GME). I will provide an overview of what is required on E-3, Part IV on 2552-96 or the new E-4 on the 2552-10. GME compensates hospitals for the costs of running a teaching …

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  • Input Pricing Under the Prospective Payment System (PPS)

    As discussed in a precious article about PPS, we discussed labor, nonlabor, and capital costs. The purpose of this brief discussion is to explain the elements in more detail, especially because of its interrelationship with the wage index computed on S-3, Part II and Part …

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  • How to Calculate Operating DSH (Disproportionate Share Hospital)

    How to calculate the operating DSH adjustment One area that sometimes confuses providers is the operating DSH calculation. We know operating DSH is important due to the DRG calculation. 1. Urban hospitals with 100+ beds. 2. Rural hospitals with 500+ beds. 3. Rural hospitals that …

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  • What is IPPS (inpatient prospective payment system) for Medicare?

    The purpose of the post is to briefly explain how to calculate operating and capital DRG (diagnosis related groups) payments. “Under the IPPS, each case is categorized into a diagnosis-related group (DRG). Each DRG has a payment weight assigned to it, based on the average …

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  • Operating and Capital Cost-to-Charge Ratios (CCR)

    The purpose of this post is to explain how Medicare calculates the operating and capital cost to charge ratios. Medicare informs that it is the latest settled or tentatively settled cost report that is used for calculating cost-to-charge ratios. First, we must obtain a statistic …

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