CMS continues to refine the uncompensated care calculation.  Three factors are utilized to calculate uncompensated care reimbursement for IPPS hospitals.  Factor 3 is developed by compiling the cost of uncompensated care that is reported on the Medicare cost report Worksheet S-10.  Effective with federal fiscal year 2020, worksheet S-10 will fully utilize uncompensated care data taken from the Medicare cost report.  It is now critical that hospitals report complete and accurate uncompensated care information.

For cost reporting periods beginning on or after October 1, 2018, Medicare disproportionate share eligible hospitals must submit a patient-level listing of charity care and/or uninsured discounts as part of their cost report supporting documentation. CMS has not yet provided comprehensive instructions on what data elements will be required as part of this detail listing.

At the direction of the CMS, the MACs have recently been sending out Additional Documentation Requests regarding the information claimed by hospitals on the FY 2015 Worksheet S-10.  The requests have been very extensive and detailed.  In addition, the time frame for responding to the requests has been short.

To prepare for these changes, hospitals should review financial assistance policies to ensure compliance. In addition, hospitals must determine that all applicable uncompensated care amounts are being captured and properly reported on Worksheet S-10.

If you require any assistance or have any questions, we are available to discuss these changes with you. Please see the appropriate state contacts listed below:

Indiana: Lisa Deaton | 317-713-7921 | ldeaton@blueandco.com

Kentucky: Nick Ficklin | 502-992-3490 | nficklin@blueandco.com

Ohio: Judith Maloney | 614-222-1377 | jmaloney@blueandco.com