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CMS proposes electronic filing

October 1, 2002

CMS proposes electronic filing

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.