Understanding HCFA-2552-92 cost reporting forms - United States.Health Care Financing Administation

Healthcare Financial Management, Oct, 1992 by W. Coleman Powell, Derek A. Pierce

Worksheet D-1 part IV includes old and new capital for the computation of observation bed days pass through cost. Since both old and new capital are added with pass through cost, this worksheet remains essentially unchanged.

Worksheet E part A calculates the inpatient hospital services under PPS settlement. Two new lines have been included for regular inpatient program capital settlement and for the exception inpatient capital payments.

Worksheet E-3 part III is generally used by hospitals filing Medicaid information that "piggybacks" the Medicare cost report. These hospitals may be required to settle Medicaid capital like Medicare capital. Since Medicaid differs among states, the reimbursement methodologies may not be similar. Several lines have been added to allow for flexibility.

Worksheet G revisions are similar to those on worksheet A-7. The provider is required to provide detailed information for old and new fixed assets.

Worksheet I-2 parts I and II are used for renal and home dialysis costs. The changes described in worksheets A and B are applicable to these worksheets.

Series L has been added to calculate the provider's capital payment status (i.e., hold harmless). For some hospitals, this status may change, especially if the hospital has obligated capital and has or is considering requesting a redetermination of its base year. This is one reason HCFA is requiring providers to complete all applicable worksheets.

Series L is divided into two worksheets: worksheet L, which calculates the capital payment for the hospital, and worksheet L-1, which calculates allowable costs for extraordinary circumstances.

Worksheet L has four parts:

Part I summarizes the hospital's total prospective payment amount.

Part II summarizes payments under the hold harmless method.

Part III summarizes inpatient Medicare reasonable capital cost.

Part IV has been created for hospitals that qualify for an exception payment. This part computes minimum payment levels by class of provider with an additional payment exception for extraordinary circumstances for hospitals paid under either the fully prospective method or the hold harmless method.

Worksheet L-1 has three parts:

Part I allocates allowable costs for extraordinary circumstances (floods, fires, and earthquakes). These costs will be allocated based on statistics used in worksheet B-1.

Part II computes the inpatient routine portion of the extraordinary item, similar to worksheet D part I.

Part III has been created to identify the inpatient ancillary portion of the extraordinary item, similar to worksheet D part II. The amount computed on this worksheet along with the amount computed on worksheet L-1 part II is added to worksheet L part IV as part of the exception payment.

The bottom line

Although the changes in the Medicare capital regulations were implemented in October of 1991, the Health Insurance Manual 15 revisions for capital PPS will not be released until sometime this fall. Cost reporting forms are due out in November and some hospitals may be pressed to complete these on time.