Death, Taxes and Medicare Bad Debt

Past DueCompleting a task every day is generally pretty easy—the routine is familiar, so we accomplish it quickly.  But those things that we only do once a month, or worse once a year, tend to be overwhelming. An example is filing your income taxes—the government recognizes the difficulty, so we have until April 15—nearly four months, to comply.

A similar challenge presents itself with the claiming of Medicare bad debt on your Medicare cost report.

Deductibles and coinsurance amounts not paid by Medicare beneficiaries can be claimed as allowable bad debts. The general rules for what can be claimed, what constitutes reasonable collection efforts and timing are contained in Chapter 3 of the Provider Reimbursement Manual 15-1.

Chapter 3 also identifies some of the required elements that should be included on a bad debt log.

Tip #13:

Evaluate if bad debt logs comply with Medicare requirements (Pub. 15-1, §314)

In addition, each Medicare Audit Contractor (MAC) has guidance for the completion of bad debt logs and we encourage you to check out the MAC websites to ensure you are following any special direction that might be applicable to you.

The general guidance can be found on the Centers for Medicare and Medicaid Services (CMS) website:

Provider Reimbursement Manual 15-1

Questions? Please contact Marie White at 612.253.6546 or mewhite@eidebailly.com.

 

 

Herding Cats to Finalize Your Cost Report? No Worries, It Can be Reopened

Stray CatsPreparing the Medicare cost report can be compared to herding cats—you have to gather a lot of data from a lot of people in a short period of time, with rules that seem to be constantly changing. So the odds of “getting it right” the first time are not very good.

The same argument applies to the audit or review of the cost report. In any given year, the Medicare Administrative Contractors (MACs) receive over 40,000 reports from different provider types—and all of these must be finalized in some fashion.

CMS recognizes the challenges of doing this and has included regulations that allow for the finalized cost report to be reopened. The same regulation allows a hospital to request a reopening if they determine something was not properly reported the first time. We recommend you read this regulation and know the process to follow if this situation arises.

Tip #12:

A settled cost report (NPR) can be reopened up to three years after its issuance (Pub. 15-1, §Section 2931.1)

Further guidance can be found on the Centers for Medicare and Medicaid Services (CMS) web

Provider Reimbursement Manual 15-1

Questions? Please contact Marie White at 612.253.6546 or mewhite@eidebailly.com.