HFS Update for HFMA MN November 7, 2019 Luke DiSabato & Becky Dolin
About HFS • Small Company in Elk Grove, CA. • 35 years experience making MCR software. • HFS makes Medicare Cost Reporting software for Hospitals, Skilled Nursing Facilities, Home Health Agencies, CMHC, RHC, FQHC, ESRD, Hospice, Home Office and OPO. • SaFE Website, HCRIS Website and IRIS Database software • Specialized Reporting for – CA, MA and VA 11/6/2019 2
Overview Agenda • MCR Update • PS&R Changes • IRIS Changes • HFS News and Improvements • New System Development • Feature Updates • Training & Support • Questions 11/6/2019 3
Transmittal Updates Form Type Latest CMS Issued HFS HFS Effective Date Transmittal Approved Released 2552-10 Hospital 15 3/16/2018 4/6/2018 4/13/2018 Ending O/A 9/30/2018 2540-10 SNF 8 3/9/2018 3/29/2018 4/6/2018 Ending O/A 12/31/2017 216-94 OPO 7 10/6/2017 3/29/2018 4/16/2018 Ending O/A 12/31/2017 1728-94 HHA 18 3/16/2018 4/6/2018 4/13/2018 Ending O/A 12/31/2017 265-11 ESRD 5 3/8/2019 4/3/2019 4/12/2019 Ending O/A 1/31/2019 224-14 FQHC 3 5/3/2019 5/31/2019 5/31/2019 Ending O/A 4/30/2019 1984-14 Hospice 3 4/13/2018 4/20/2018 4/26/2018 Ending O/A 12/31/2017 222-17 RHC 1 5/18/2018 9/7/2018 10/26/2018 Ending on or after 9/30/2018 5/18/2018 8/24/2018 10/26/2018 Ending on or 2088-17 CMHC 1 after 9/30/2018 No Recent Changes 287-05 HO 11/6/2019 4
Transmittal Updates • Please see our website for additional transmittal information 11/6/2019 5
2552-10 T-15 • 2552-10 T-15 • Published October 19, 2018 • Effective for cost reporting periods ending on or after 9/30/2018 • Worksheet S-2 added 2 provider types • 10 = Extended Neoplastic Disease Care (previous subclause (II) LTCHs) • 11 = Indian Health Services • Implement FY 2019 LVA changes • 42 CFR 412.101(c)(3) provides for a temporary change in the low-volume adjustment for qualifying hospitals for FFYs 2019 through 2022 as follows: • Those hospitals with 500 or fewer total discharges will receive an adjustment of an additional 25 percent for each Medicare discharge; and, • Those with more than 500 and fewer than 3,800 total discharges will receive an adjustment of an additional percentage for each Medicare discharge. This adjustment is calculated using the formula [(95/330) - (total discharges/13,200)]. • To qualify as a low-volume hospital, the hospital must meet both of the following criteria: • Be more than 15 road miles from the nearest subsection (d) hospital; and, • Have fewer than 3,800 total discharges based on the hospital’s most recently submitted cost report. 11/6/2019 6
Adjustment for Low Volume Hospitals • Section 50204 of the Bipartisan Budget Act of 2018 Modified LVA • CR10869 issued 10-4-18 states the following: 11/6/2019 7
Adjustment for Low Volume Hospitals • No Table of LVA Factors for FFY 2019 • MACs will compute factor based “using the hospital’s total discharges in its most recently submitted cost report as of the time of the MAC’s low - volume hospital status determination”. • Then factor input on Exhibit 4: 11/6/2019 8
2552-10 T-15 • 2552-10 T-15 (Continued) • Wage Index Changes • Worksheet S- 3, Part II, line 18 “Other Wage Related Costs” • Not completed for cost reporting periods beginning on or after 9/30/2018. • Same With S-3, Part IV, line 25 • Worksheet E, Part A • Outliers to be split by FFY for CR periods beginning on/after 10/1/2018 • I Series • Treatments reported for Acute Kidney Injury 11/6/2019 9
2552-10 T-15 • 2552-10 T-15 (Continued) • New Edits • 13255S The amount on Worksheet S-3, Part II, line 18, column 4, must equal the sum of Worksheet S-3, Part IV, line 25, and subscripts. Effective for cost reporting periods beginning on or after October 1, 2018, Worksheet S-3, Part II, line 18, column 4; and Worksheet S-3, Part IV, line 25, and subscripts, must equal zero. [09/30/2017] • 13260S For cost reporting period beginning on or after October 1, 2015, Worksheet S-3, Part II, line 14, columns 2, 3, 4, 5, and 6, must equal zero. For cost reporting periods beginning prior to October 1, 2015, Worksheet S-3, Part II, lines 14.01 and 14.02, columns 2, 3, 4, 5, and 6, must equal zero. [09/30/2018] • 13267S Worksheet S-3, Part III, line 1, columns 4 and 5, must be greater than zero for IPPS providers. [09/30/2018] • 13270S For cost reporting period beginning on or after October 1, 2015, Worksheet S-3, Part IV, line 8, must equal zero. For cost reporting periods beginning before October 1, 2015, Worksheet S-3, Part IV, lines 8.01, 8.02, and 8.03, must equal zero. [09/30/2018] • 10225E If Worksheet S- 2, Part I, line 60, is “N”, then Worksheets E, Part A, line 53; E - 3, Part I, line 1.01; E-3, Part II, line 13; E-3, Part III, line 14; E-3, Part IV, line 4; and E- 3, Part V, line 2; must be zero. [09/30/2018] 11/6/2019 10
Proposed Form Set 1728-19 • Notice of Draft published in 4/16/2019 Federal Register • 60-Date comment period ending 6/17/2019 • Draft available at https://www.cms.gov/Regulations-and- Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-1728- 19.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending • Proposed effective date cost reporting periods beginning on or after January 1, 2019, and ending on or after December 31, 2019. 11/6/2019 11
NEW FORM SETS • CMS Published 5/18/2018 • Effective for cost reporting periods ending on or after 9/30/2018 • 222-17 Free-Standing RHC • Or part of HHA/SNF • Hospital-based on 2552-10 • 2088-17 Free-Standing Community Mental Health Center (CMHC) • BOTH SYSTEMS DEVELOPED/APPROVED/RELEASED 11/6/2019 12
Amended Cost Report Clarification • Amended Cost Report Clarification • With the S-10 amended cost reports, we noticed many users were incorrectly identifying the EC file when it is an amended cost report. When you amend a cost report, you open up W/S S and select the S Part I tab and then on line 5 you change the mcr code to 5- Amended and change line 3 to 1 for 1 st amended. 11/6/2019 13
Amended Cost Report Clarification • Amended Cost Report Clarification • Then when you do an ECR Export, you keep the EC Option submission still as 1 st , only change this if you have 2 cost reports in the same calendar year (like a 6- 30 and 12-31 due to CHOW). The EC file extension changes, like below to a 17A2. 11/6/2019 14
Amended Cost Report Clarification • Amended Cost Report Clarification • As you can see on the prior slide, we made a change to identify State Medicaid Submissions that users may want to use, in this case it is still an Amended cost report so the 1 st XIX is 17E2, 2 nd would be 17F2 & we allow for 22 nd XIX submission being 17Z2. 11/6/2019 15
Electronic Filing • MCReF • The 287-05 (Home Office) form set has not been updated with the electronic signature language. Providers are able to upload the files to MCReF but the signed Schedule A page must be mailed into the MAC and still meet the original signature criteria that the MAC requires now. 11/6/2019 16
PS&R Changes - Hospitals • We have received statements from many clients saying our PS&R Reconciliation is difficult to use when you have Sub-providers that have different allocation basis than the Hospital. Below is a revision we just released: 17
PS&R Changes - Hospitals • We have done this for Psych, Rehab, SNF and Swing Bed SNF units. The Provider is the Hospital and the others will be identified by provider #. When you import the Extract, we will populate the Rev Codes located in the csv file for that particular unit. 18
PS&R Changes - Hospitals • If you have a rev code that is split to more than 1 cost center, you want to establish a stat code in the User Define Statistics at left side (see next slide). • In the Provider Cross Reference, you zero out the W/S A line # and enter the stat code. If Pt B % split is different than Pt A, you will set up a 2 nd stat code and enter the Pt B in the Override for Pt B Stat Code column. 19
PS&R Basics - Hospitals 20
PS&R Basics - Hospitals 21
HFS IRIS Program • The HFS IRIS program is SQL based that allows for Check for Updates and Net Sync that we have in the Medicare Cost Report software. • We allow for manual entry of data but also import information that is prepared in excel using a specific template. 22
IRIS Data Entry • The file has to use a specific format with the headers that are from the CMS’ M & A structure shown as follows and we have a link on our IRIS page for the csv file https://www.hfssoft.com/doc/Consolidated.csv 23
IRIS Data Entry • We suggest to open up the PY M.dbf file in Excel, you need to open Excel first then do a File – Open and change the type of file from Excel Files to All Files: 24
IRIS Data Entry • Then you would copy the M file data from SSN to FYEND (see below) to the consolidated csv file opened in excel: 25
IRIS Data Entry • Please note that the Master’s RESYEAR column is not in the consolidated file so you will need to delete those records and shift cells left: 26
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