Medicare Cost Reports 2012
Providers of service participating in the Medicare program are required to submit information to achieve settlement of costs relating to health care services rendered to Medicare beneficiaries [42 U.S.C. 1395g (section 1815(a) of the Social Security Act]. Regulations state that Medicare Cost Reports & Medicaid Cost Reports “will be required from providers on an annual basis…”[42 C.F.R. §413.20(b)]. When a provider fails to file a timely Medicare Cost Reports, all interim payments since the beginning of the Medicare Cost Reports reporting period can be deemed overpayments. (See Part I, §2413.)
MEDICARE COST REPORTS REPORTING PERIOD
For Medicare Cost Reports & Medicaid Cost Reports reporting purposes, Medicare requires submission of annual reports covering a 12-month period of operations based upon the provider’s accounting year.
The provider may select any annual period for Medicare Cost Reports & Medicaid Cost Reports purposes regardless of the reporting period it uses for other programs. Once a provider has made a selection and reported accordingly, it is required thereafter to report annually for periods ending as of the same date unless the contractor/contractor approves a change in the provider’s reporting period.
Medicare Cost Reports & Medicaid Cost Reports reporting period under the program consisting of one of the following will be considered in compliance with the reporting periods cited above:
A. Twelve (12) successive calendar months,
B. Thirteen (13) four-week periods with an additional day (two in leap year) added to the last week or period to make it coincide with the end of the calendar year or month,
C. A reporting period which will vary from 52 to 53 weeks because it must always end on the same day of the week (Monday, Tuesday, etc.) and always end on (1) whatever date this same day of the week last occurs in a calendar month, or (2) whatever date this same day of the week falls which is nearest to the last day of the calendar month, even though this same day falls in the first week of the following month. A new provider beginning operations on January 1, 2011, and entering the program as of that date, could choose a reporting period beginning with that date and ending, for example, Wednesday, December 27, 2011. This provider’s accounting period would end on the same day of the week (Wednesday) and on whatever date that day of the week last occurs in the final month of the year. Alternatively, the provider could elect to end its first reporting period on January 1, 2012; this would be based on the election to end the period on the same day of the week which is nearest to the last day of the calendar year, even though the last day falls in the first week of the following month. The method selected must be consistently followed.
A provider may prepare a short period Medicare Cost Reports & Medicaid Cost Reports for part of a year under the circumstances described in §§102.1 through 102.3.
Where a provider did not furnish any covered services to Medicare beneficiaries or where it had low utilization of such services in a reporting period, a full Medicare Cost Reports & Medicaid Cost Reports need not be filed. See §110 for an explanation of this procedure.
Providers in a chain organization, or other group of providers, are required to file individual Medicare Cost Reports & Medicaid Cost Reports as explained in §112.
Initial Cost Reporting Period.–In order to conform its initial Medicare Cost Reports & Medicaid Cost Reports reporting period to the annual reporting period it wishes to use, a provider may be permitted or required under the circumstances outlined below, to file its first Medicare Cost Report & Medicaid Cost Reports covering less than or more than a year (as defined below) of provider operations. The ending date (or day) chosen by the provider for its initial reporting period is presumed to be the ending date (or day) the provider elects for its subsequent annual reporting periods.