CMS has instructed Medicare Administrative Contractors (MACs) to audit provider cost report data reported on Worksheet S-10. The focus of the audits is on charity and bad debt adjustments reported that are now being utilized to distribute Medicare Uncompensated Care payments. The MACs are reviewing policies that govern which patient accounts receive these adjustments and reconciling amounts back to supporting documentation.
The following are items CMS is requesting:
- Copies of charity and financial assistance policies
- Logic used in pulling adjustment amounts that were previously reported
- Detail patient listings of adjustments that include the original charges at a revenue code level
- Reconciliation of reported amounts to the provider’s financial records
- Comparison of amounts reported to the prior year
Medicare cost reports beginning in FFY 2015 comprise the audit population. We are seeing that some of the MACs are subcontracting this audit work out. Initial letters to providers are requesting a two-week turnaround from the request for information.
If you have any questions or need assistance with these audits, please contact our Albany office at (229) 883-7878 or our Atlanta office at (404) 220-8494 as soon as possible.