Cost Report Reopenings for JM

Published 12/15/2020

Palmetto GBA has updated their cost report reopening guidelines for Jurisdiction M and is presenting the following information as official notification of changes and clarifications to existing guidelines. 

Materiality Threshold
For cost report reopenings, the reimbursement impact at the time of the request must equal or exceed $10,000 and will be applied to any reopening request received.

Issue Submission, One Time Only
A reopening request for a specific issue should only be submitted once. If the reopening request was previously submitted and is being requested again based on Alert 11, the reopening requests must submit a copy of the initial reopening request with the Alert 11 request. See
PRRB dated July 01, 2015, rule #46.2 (PDF, 2.25 MB).

All supporting documentation should be submitted with the reopening request and must include the reimbursement impact of the reopening. The reimbursement impact should be itemized for each issue requested. Providers must also document why the information or issue is new and material to the facility. If applicable, a provider must include a statement which supports the reason why the information was not available at the time of filing the cost report. 

If supporting schedules/listings are submitted with the reopening request, Excel format is the preferred format. If the reopening request is submitted by a third party on behalf of the provider, the request must include written confirmation from the provider for agent authorization. The confirmation must indicate that the authorization is applicable to the specific reopening request.

Palmetto GBA’s determination to grant the reopening request will include an evaluation of all of the above factors.  Palmetto GBA will contact the provider within 90 days of the specific reopening request.

Electronic Submission Process
Please submit your cost report reopening request and supporting documentation in a secure electronic format – through the JM reopening mailbox at the following e-mail address:

 Courier Service
Palmetto GBA
Cost Report Reopenings
Mail Code AG-380
Post Office Box 100144
Columbia, SC 29202
Palmetto GBA
Cost Report Reopenings
Mail Code AG-380
2300 Springdale Drive, Building One
Camden, SC 29020-1728

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