To: Freestanding HHA providers
Subject: Various Freestanding HHA (Form CMS 1728-94) IssuesTransmittal 13
Date: July 3, 2007
The Centers for Medicare and Medicaid Services (CMS) has issued clarification to various issues relating to the Freestanding HHA Medicare cost report (Form CMS 1728-94, Transmittal 13). The revised instructions and affected worksheets are outlined below. (Items in bold represent revisions.) All affected providers are instructed to implement the appropriate action effective immediately.
Worksheet A:
Line 13, 4th paragraph:
In accordance with Change Request 4240, dated March 17, 2006, effective for services rendered on or after July 1, 2006, the cost of administering pneumococcal, influenza, and hepatitis B vaccines is reimbursed under the outpatient prospective payment system (OPPS), but the actual cost of the pneumococcal, influenza, and hepatitis B vaccines will remain cost reimbursed. For cost reporting periods ending on or after July 1, 2006, enter on this line the vaccine cost (exclusive of the cost to administer these vaccines) incurred for pneumococcal, influenza, and hepatitis B vaccines. Continue to include the cost of osteoporosis vaccines and the cost of administering the osteoporosis vaccines on this line.
Line 13.20.--Enter the cost incurred to administer pneumococcal, influenza, and hepatitis B vaccines. Use cost center code 1320 in accordance with table 5 of the electronic reporting specifications for the appropriate cost center code.
Worksheet C:
Lines 15 and 16.--Enter in column 2 the total applicable costs for the entire cost reporting period for each line item from Worksheet B, column 6, lines 12 and 13, respectively (the costs entered on lines 15 and 15.01 must be equal; the costs entered on lines 16 and 16.01 must be equal). Enter in column 3 the total charges for the entire cost reporting period for each line (the charges entered on lines 15 and 15.01 must be equal; the charges entered on lines 16 and 16.01 must be equal). The language in the two preceding parentheticals is only applicable for cost reporting periods which overlap October 1, 2000. For cost reporting periods ending on or after July 1, 2006, enter in column 2 the total charges for services rendered on or after July 1, 2006 on lines 15, 16, and 16.20, respectively. Enter in column 4 the ratio of costs (column 2) to charges (column 3) for each line.
Line 16, 4th paragraph:
Effective for cost reporting periods ending on or after July 1, 2006 (see section 3206, line 13), line 16 represents pneumococcal, influenza, and hepatitis B vaccines, and osteoporosis drugs, but not the administration of these vaccines. See the chart below for proper placement of charges.
Worksheet D, Part I, line 1, 3rd paragraph:
For cost reporting periods ending after July 1, 2006 (see §3206, line 13), transfer the cost of pneumococcal, influenza, and hepatitis vaccines from Worksheet C, Part III, column 9, line 16, to column 2 of this worksheet, and the cost of osteoporosis drugs from Worksheet C, Part III, column 10, line 16 to column 3 of this worksheet. Also transfer the administration of pneumococcal, influenza, and hepatitis B vaccines from Worksheet C, Part III, column 9, line 16.20, to column 2 for the portion of the reporting period before July 1, 2006.
Edits:
2011C |
If the sum of Medicare visits on Worksheet S-3, column 1, lines 1-6 and Worksheet S-3, Part IV, column 7, lines 30, 32, 34 ,36, 38, and 40 are greater than zero, respectively (for each discipline), then the corresponding cost on Worksheet B, column 6, lines 6-11 must also be greater than zero and vice versa. [10/1/2000] |
1040S |
On Worksheet S-2, if the response to columns 1, 2 and 3, line 29 is 'Y', then there must be a response on line 29.01, columns 1, 2 and 3; line 29.02, column 1 or 2; line 29.03, columns 1, 2 and 3 and conversely, if the response to column 1, line 29 is 'N', then there must be no response on line 29.01, columns 1, 2 and 3; line 29.02, column 1 or 2; line 29.03, columns 1, 2 and 3 . [1/31/2007] |