The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would require hospices and other organizations to file annual cost reports using a standardized electronic format. The proposal appears in the July 26, 2002, Federal Register, and would be effective Dec. 31 for cost report filing periods ending on or after that date.
There is, however, a waiver option if those affected by the proposed rule can prove financial hardship as a result of having to meet the new guidelines. There will be a 60-day comment period for the proposed rule, after which CMS will review the comments and issue a final rule.
The rule would apply guidelines currently in place for skilled nursing facilities and home health agencies to hospices, organ procurement organizations, rural health clinics, federally qualified health centers, community mental health centers, and end-stage renal disease facilities. One exception is that for the first two years of implementation of the new rule, a hard copy of the cost report must be submitted with the electronic cost report, CMS said. Over that two-year period, the hard copy would continue to be the official copy.
The CMS said the move would be beneficial because the cost reporting software for these reports "will virtually eliminate computational errors and substantially reduce preparation time. Moreover, the use of cost reporting software will save time whenever the provider needs to change individual entries in a cost report."
Since 2000, CMS has required hospices to file cost reports for the following cost centers in their organizations:
General Services
Capital related - buildings and fixtures
Capital related - moveable equipment
Plant operations and maintenance
Transportation - staff
Volunteer services coordination
Administrative and general
Inpatient Care Services
Inpatient - general care
Inpatient - physician services
Inpatient - respite care
Inpatient - physicians, respite care
Medical social services, inpatient
Visiting Services
Physician services
Nursing care
Speech therapy
Medical social services
Occupational therapy
Spiritual counseling
Dietary counseling
Other counseling
Home health aide
Homemakers
Other visiting services
Other Hospice Service Costs
Drugs and biologicals
Durable medical equipment/oxygen
Patient transportation
Imaging services
Lab and diagnostic
Medical supplies
Outpatient services, including emergency room services
Infusion therapy
Radiation therapy
Other
Non-reimbursable Services
Bereavement program costs
Volunteer program costs
Fundraising
Other program costs
The report is expected to provide CMS with information to help determine future reimbursement. This information could be used to modify payment rates, establish provider-specific payment rates, set base years for determining future rates, be used to stimulate future legislation, indicate specific provider problems to CMS, and more.
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