Reimbursement Consulting

UPDATED NOVEMBER 2023

CMS issued a Transmittal 18 on December 29, 2022, for the hospital cost reporting Form 2552-10. 本传送文作了几处改动, but what affects almost all hospital providers are the updated Medicare Bad Debt (Exhibit 2a) and S-10 (Exhibits 3b and 3c) exhibits below which were made a requirement in this transmittal. These exhibits are required for cost reporting periods ending on or after September 30, 2023.

• Exhibit 2a -从2022年10月1日开始及之后的成本报告期间的医疗保险坏账日志
• Exhibit 3b -慈善护理费用的S-10日志
• Exhibit 3c - S-10总账坏账记录

More detail of Transmittal 18: http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Transmittals/r18p240i

LBMC is prepared to assist all providers regulated by this transmittal and to assist in the preparation of these exhibits.

POSTED JANUARY 2023

What affects almost all hospital providers are the updated exhibits below which were made a requirement in this transmittal. This transmittal affects providers for cost reporting periods beginning on or after October 1, 2022.

• Exhibit 1 -分配医生报酬
• Exhibit 2 - 2022年10月1日之前开始的成本报告期间的医疗保险坏账日志.
• Exhibit 2a -从2022年10月1日开始及之后的成本报告期间的医疗保险坏账日志
• Exhibit 3a -在符合DSH条件的医院享受医疗补助的天数
• Exhibit 3b -慈善护理费用的S-10日志
• Exhibit 3c - S-10总账坏账记录

The 2023 appropriations bill provides for funding levels for several rural health programs.  该法案于2022年12月29日由拜登总统签署.

$5 million was designated in this bill to establish an Office of Rural Health at Centers for Disease Control and Prevention (CDC). This Office of Rural Health at the CDC will enhance implementation of CDC’s rural health portfolio, coordinate efforts across CDC programs and develop strategic plan for rural health.

This bill also supports rural hospitals 以及核心农村卫生保健项目，具体如下:

Rural Hospital Programs

• $3.45 billion for the 农村社区设施计划 and $2 million for the 农村医院技术援助方案 through the United States Department of Agriculture Rural Development (RD) programs.
• $64.3 million for the 医疗保险乡村医院弹性补助计划(比2022财年的资金水平增加了200多万美元). The $64.3 million includes $21 million for the Small Rural Hospital Improvement Grant Program and $5 million to continue funding the Rural Emergency Hospital (REH) TA Program.

继续实施农村核心卫生保健方案

• $12.国家农村卫生办公室500万美元(一级供资)
• $145 million for the Rural Communities Opioids Response Program ($10 million increase)
• $12.500万美元用于农村居民发展计划(增加200万美元)
• 1.25亿美元用于国家卫生服务团(增加300万美元)
• $8 million for the Rural Maternity and Obstetrics Management Strategies (RMOMS) Program at HRSA ($2 million increase)

2010年法定现收现付法(PAYGO)

The 2010年法定现收现付法(PAYGO) required a mandatory spending and revenue legislation to not increase the federal budget deficit.  The PAYGO sequester was waived through 12/31/22 with the passage of the American Rescue Plan Act.  PAYGO sequester is now deferred until January 2025, which avoids a 4% cut to Medicare reimbursement.

Telehealth

远程医疗的灵活性现在将持续到2024年12月31日. In the FY 2022 omnibus appropriations bill extended telehealth flexibilities for 151 days post-PHE. 该法案扩展了这些关键的公共卫生条款, 包括到12月31日的纯音频灵活性, 2024.

Medicare Payments

• 小容量医院(LVH)和依赖医疗保险的医院(MDH)指定 都延长到2024年9月30日.
• 地面救护车附加付款 延长两年至2024年12月31日.
• Physician add-on payments 对于在2023日历年提供的服务，附加付款将为2.5 percent for physicians. 对于在2024日历年提供的服务，附加付款将为1.25 percent.
• 农村家庭医疗补助 到2023年底，只占1%.

Mental Health Provisions

• Coverage of Marriage and Family Therapists (MFT) and mental health counselors (MHC) under Medicare.
• Inclusion of 200 new residency slots for psychiatry or psychiatry subspecialties. In FY 2026, 秘书应开始分配这些名额, 至少有10%的资金流向农村地区的医院.
• 纳入《明升体育app下载》

这是美国医院协会关于这1美元通知的链接.7 trillion omnibus bill.  http://www.aha.org/news/headline/2022-12-30-biden-signs-17-trillion-omnibus-appropriations-bill

Cost Reporting Services

• 准备和/或审查医疗保险和/或医疗补助成本报告.
• 审查和协助临时解决方案, cost report audits, 申诉和其他与CMS和mac的通信.
• Review of previously filed cost reports in order to identify potential exposure and reimbursement opportunities.
• Compilations or independent review of various Medicaid and other State Program Reports such as Residential Treatment Centers.

付款人合同和谈判

• Chargemaster Reviews
• 审查所有当前合同的合规性, 执行并与付款人重新谈判, as appropriate, 获得更有利的合同条件和/或费率.
• 审查所有新合同提案并提出接受或拒绝的建议, 根据潜在的表现和符合集团的战略和目标.
• 回顾你所在地区的支付方市场份额和新合同建议.
• Provide telephone and email support to your staff on questions related to payor contracts.
• 对付款人遵守合同的情况进行持续监测.
• Project environments: Hospitals, ASC, Rehab, 精神科(住院及门诊), 医生(医院和非医院)和辅助服务.

Consulting Services

• Identify and assist with opportunities for Disproportionate Share (DSH) and Low Income (LIP) reimbursement for medical/surgical and rehabilitation hospitals, respectively.
• Assist in compiling and/or review of traditional Medicare Bad Debts and Medicaid “crossover” Bad Debts.
• 为合理的成本分配进行面积分析.

Other Reimbursement Services

• Assist with Wage Index audits and review for potential Geographic reclassifications.
• 针对提供商的各种问题进行咨询.
• 协助完成和归档职业组合调查.
• Due diligence to assist with opportunities and liabilities with acquisition/merger activities.