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Alerts

Jul 06, 2017

Change in Low – Utilization Cost Report Qualification

Effective for fiscal periods beginning 1/1/2017 or later, the criteria for filing a low-utilization Medicare cost report, as established by the Center for Medicare and Medicaid Services, has changed. Previously, providers were allowed to file a low-utilization Medicare cost report if one of the following criteria were met:
 
  • Net Part A and Part B reimbursement of $200,000 or less
  • Less than 10 percent Medicare utilization (days/visits)
Under the new eligibility criteria, the only requirement to file a low-utilization Medicare cost report is net Part A and Part B reimbursement of $200,000 or less.

The secondary criteria of less than 10 percent Medicare utilization has been eliminated.

Due to this change in eligibility requirement, many providers that once qualified to file a low-utilization Medicare cost report will no longer qualify and will be required to file a full Medicare report.

The full Medicare report is much more comprehensive than a low-utilization report and will require additional information to complete depending on the provider type including, but not limited to:
 
  • Square footage
  • Detail of hours paid by department
  • Part A Log
  • Provider Statistical and Reimbursement Report (PS&R Report)
More detailed guidance will be forthcoming, however, as the remainder of the fiscal period progresses, keep in mind the need to gather this type of additional information in order to ensure timely and accurate reporting.

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