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New Documentation Requirements for Filing Medicare Cost Reports

Attention: The FY 2019 Medicare IPPS final rule changed the required supporting documentation that must be submitted with the Medicare cost report. CMS also published MLN Matters article SE19015 on 8/21/2019 which further outlines the new documentation requirements.

Cost reports submitted for cost reporting periods beginning on/after 10/1/2018 must meet these supporting documentation requirements.  For cost reports received 12/31/2020 and later, submissions that do not contain the required documents will be rejected for lack of supporting documentation (per Section 413.24(f)(5)(i)).

  • Teaching Hospitals – A cost report will be rejected for lack of supporting documentation if it does not include the Intern and Resident Information System data.
  • Bad Debts - For providers claiming Medicare bad debt reimbursement, a cost report will be rejected for lack of supporting documentation if it does not include a detailed bad debt listing that corresponds to the amount of bad debt claimed in the cost report.
  • Disproportionate Share Hospital (DSH) Eligible Hospitals – For hospitals claiming a DSH payment adjustment, a cost report will be rejected for lack of supporting documentation if it does not include a detailed listing of the hospital’s Medicaid-eligible days that corresponds to the Medicaid-eligible days claimed in the hospital’s cost report.
  • Charity Care and Uninsured Discounts – For DSH-eligible hospitals reporting charity care and/or uninsured discounts, a cost report will be rejected for lack of supporting documentation if it does not include a detailed listing of charity care and/or uninsured discounts that corresponds to the amounts claims in the DSH-eligible hospital’s cost report.
  • Home Office Cost Allocations – For providers claiming costs on their cost reports that are allocated from a home office or chain organization, a cost report will be rejected for lack of supporting documentation if the home office or chain organization has not submitted a Home Office Cost Statement to the chain provider’s servicing contactor.

Questions regarding your Cost Report filing:

Posted 1/8/2021

Last Modified: 1/8/21
New Documentation Requirements for Filing Medicare Cost Reports
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