Submission Requirements

Home Provider Part A Medicare Areas Audit and Reimbursement

This information is provided by WPS, Medicare Audit & Reimbursement area. An acceptable Medicare cost report means that all of the following items have been included in the submission. This includes:

From all providers filing electronic cost reports (ECRs):

  1. A diskette of the ECR utilizing a CMS-approved vendor with the current specification date submitted.
    Note: All Hospitals and all Skilled Nursing Facilities (SNFs) are required to file an electronic cost report.
  2. An ECR that passes all Level 1 edits.
  3. A submitted print image file of the cost report except when using CMS free software.
  4. The certification page (Worksheet S) of the ECR file with the actual signature of an officer (administrator or chief financial officer).
  5. An exact match of the encryption code, date and time for the ECR displayed on the certification page to that of the ECR file encryption code, date and time.
  6. An exact match of the encryption code, date and time for the print image displayed on the certification page to that of the print image file encryption code, date and time except when using CMS free software.
  7. For teaching hospitals, a complete Intern and Resident Information System (IRIS) diskette that will pass all IRIS system edits.
    IRIS Programs
  8. The settlement summary on the electronic certification page agrees with the settlement summary on the Medicare cost report produced from the electronic file. (Prior to rejection confirm that the settlement summary difference is not caused by the intermediary automated data reporting (ADR) vendor system.)
  9. A completed, signed and submitted Form HCFA-339 with an original signature.

For all other providers:

  1. A completed and legible cost report on the proper forms.
  2. A general information and certification page which includes the original signature of an officer (administrator or chief financial officer).
  3. A completed, signed and submitted Form HCFA-339 with an original signature.

Additionally, the following items (1-7) must be submitted with the provider's cost report. However, if the provider fails to submit any of these items, the FI will immediately notify the provider in writing that its cost report submission was incomplete. If the provider fails to provide the required documentation within the prescribed timeframes, the FI will adjust costs at Tentative Settlement.

For all providers as appropriate, ensure that the following items are present. This includes:

  1. Correctly updated graduate medical education (GME) per resident amounts.
    Note: Providers will need to include their support of how they determined the GME per resident amount used in the cost report.
  2. All required documentation per Form HCFA-339 (Complete Exhibit 1 of the Acceptability Checklist to verify the submission)
  3. Documentation supporting exceptions to level 2 ECR and hospital cost report information system (HCRIS) edits.
  4. A copy of the working trial balance.
  5. A copy of the audited financial statements where applicable.
  6. Where applicable, the supporting documentation for reclassifications, adjustments, related organizations, contracted therapists, and protested items.

KEY NOTE: If any of the 7 additional items noted above are missing, providers will be given additional time to submit missing information. If no response, Contractors are instructed to adjust the impacted cost at Tentative Settlement. This is In accordance with the issuance of Program Memorandum (PM) A-01-82, Change Request #1468 and revised with PM A-02-081, CR# 2300.

If you have any questions regarding the information on this page for cost report requirements, please feel free to contact an Audit Supervisor at 1-866-734-9444. Also, please refer to our Contacts page if you have questions that are not answered here.

Please refer to our Cost Report Due Dates page for more information on cost report filing.

Page Last Updated: Tuesday, 15-Jul-2008 10:37:28 CDT