Medicare Hospital Cost Report Changes

On December 29, 2022, CMS issued Transmittal 18 of the hospital cost report Form 2552-10. The following highlights from the Transmittal are effective for cost reporting periods beginning on or after October 1, 2022.

If a provider seeks reimbursement for Medicare bad debts, new Exhibit 2A — Listing of Medicare Bad Debts must be submitted with the cost report.
If the provider is an IPPS hospital eligible for Medicare DSH payments, the following new Exhibits must be submitted with the cost report:
1. Exhibit 3A — Listing of Medicaid Eligible Days for a DSH Eligible Hospital
2. Exhibit 3B — Charity Care Listing
3. Exhibit 3C — Listing of Total Bad Debts
In addition to reporting uncompensated care on Worksheet S-10 for the entire hospital complex as done in previous years, providers will also report data for only inpatient and outpatient services billed under the hospital CCN.
Lines have been added to identify the following:
1. IPPS hospitals participating in the CHART model beginning in 2024
2. permanent adjustments to TEFRA target amounts
3. providers purchasing greater than 50% of total professional services (e.g., legal and management/consulting services) from an unrelated organization located outside of the main hospital’s local area labor market
4. the number of temporary expansion COVID-19 public health emergency (PHE) acute care beds
5. costs related to CAR T-cell for immunotherapy infusion, Medicare-enrolled opioid treatment programs, and allogeneic HSCT acquisition
6. IPF and IRF hold harmless teaching adjustments during the PHE
Modified the method of calculating direct GME payments to a teaching hospital when the hospital’s weighted FTE counts exceed their direct GME FTE cap
Implemented IME and GME changes included in Sections 126, 127 and 131 of the Consolidated Appropriations Act, 2021