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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

CMS Releases Revised Hospital Cost Reporting Forms

May 14, 2010

The Centers for Medicare and Medicaid Services (CMS) April 30 posted to the agency's Web site a revised version of the hospital cost report and instructions. CMS solicited comments on proposed changes to the entire cost report in a Federal Register notice dated July 2, 2009, and the AAMC submitted an Aug. 31, 2009, comment letter urging CMS to address various concerns with the proposed changes [see Washington Highlights, Sept. 4, 2009]. The revised forms appear to be effective for cost reporting periods beginning May 1, 2010, and CMS is not soliciting any additional comments on the revised forms.

Among changes to several of the cost report worksheets, CMS revised from the agency's original draft proposal Worksheet S-10, which requests significant data on Medicaid and indigent care costs and payments. One of the changes the AAMC recommended in its comment letter, which CMS accepted, was to add a line that reflected the hospital's total unreimbursed costs. Note that charity care data from Worksheet S-10 will now also be used in calculating hospital Medicare health information technology (HIT) incentive payments.

CMS also consolidated information from Worksheet E-3, Part VI, which dealt with the redistribution of resident cap slots under Section 422 of the Medicare Modernization Act (MMA), into Worksheet E-4 for direct graduate medical education (DGME) payments and Worksheet E Part A for indirect medical education (IME) payments. The agency also included a new Worksheet E-1, Part II, for HIT incentive payments.

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806