In the coming months, an important topic that will become a priority for many home health and hospice agencies is the submission of your annual Medicare Cost Report.
The OIG recently released a report after auditing Cost Reports to evaluate whether Medicare MACs were effectively overseeing Medicare Cost Report filings. Their findings were less than favorable.
The OIG was highly concerned about the 70% failure rate of Medicare MACs in overseeing Cost Reports. As a result, they have issued recommendations to CMS, and we anticipate an increase in audits and oversight by Medicare MACs in the near future.
Before the PPS system, when home health agencies operated under a cost reimbursement model, the Medicare Cost Report was the most critical document, directly affecting their reimbursement. With the shift to PPS over the years, the Cost Report has become less significant for individual agencies but remains essential on a broader scale.
What does this mean? It means that CMS continues to use data from Medicare Cost Reports to determine future payment rates. If these reports are not accurate, they can directly impact future reimbursement. The same holds true for hospice providers.
It’s concerning to realize that as CMS collects Cost Report data each year, a significant percentage of reports are excluded from calculations due to inaccuracies.
It is strongly urged that you be meticulous in gathering cost report data for your home health or hospice agency throughout the year. It’s crucial that the reports you submit to CMS are as accurate as possible. Make sure you’re hiring a qualified professional to complete them, rather than just anyone who can fill out a form.
It’s essential that an experienced professional prepares your Cost Reports and that you provide them with the most accurate and detailed information possible. CMS continues to use this data to determine future payment rates, making accuracy extremely important.
Following the OIG investigation, we expect increased oversight and a higher likelihood of cost report rejections during the filing process. For those unfamiliar with the submission timeline, the annual cost report is due by the last day of the fifth month after your fiscal year ends, meaning the deadline may vary depending on your fiscal year.
HPS stands ready to assist your home health or hospice agency with any regulatory requirements related to your cost reporting. Please don’t hesitate to reach out to us.
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