Medicare: Uniform Electronic Cost Reporting For Skilled Nursing Facilities, Home Health Agencies
Legal Eagle Eye Newsletter for the Nursing Profession
January 1996
Quick Summary: A proposed new HCFA regulation would require all skilled nursing facilities and home health agencies to submit cost reports in a standardized electronic format, for cost reporting periods beginning on or after October 1, 1995.
The first electronic cost report would be due February 28, 1997. FEDERAL REGISTER, December 5, 1995, Pages 62237 - 62241.
According to HCFA, approximately seventy-five percent of skilled nursing facilities and home health agencies are currently submitting paper copies of their electronically prepared cost reports to their fiscal intermediaries. The new regulation just proposed by HCFA would have little or no effect on these providers, except to reduce the time involved in copying and collating a hard copy of the report for intermediaries. The provider would no longer be required prepare and mail a copy of the report. Instead, the completed cost report would be electronically filed with the fiscal intermediary. That is, according to HCFA, the provider would submit a disk containing the required report data to the fiscal intermediary.
The proposed new regulation would have an impact on those providers who do not prepare electronic cost reports, some of whom may have to purchase equipment, obtain the necessary software, and train staff to use the software. HCFA has noted that there are seventeen commercial software vendors servicing skilled nursing facilities and home health agencies who have HCFA-approved software programs available capable of producing an electronic cost report.
HCFA has developed a software package to enable skilled nursing facilities and home health agencies to generate an electronic cost report. To receive the free software, providers may contact their intermediaries or send a written request to:
Health Care Financing Administration, Division of Cost Principles and Reporting, Room C5-02-23, Central Building, 7500 Security Blvd., Baltimore, Maryland 21244-1850.
Providers have the option of using the software available from HCFA or of using a HCFA-approved software package provided by a commercial vendor.
If a skilled nursing facility or home health agency believes that this requirement would cause a financial hardship, it may submit a written request for waiver or delay of the new requirements to the provider’s intermediary at least 120 days before the end of the provider’s cost reporting period. The intermediary will forward the request to HCFA within 30 days, with its recommendation regarding approval or denial. HCFA would then respond to the intermediary after an additional 60 days.
Requests for delay or waiver will be considered on a "case by case" basis, according to HCFA.