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TO: Nursing Facilities
Cost Reporting Periods
The
12-month cost report for the period July 1, 2019 through June 30, 2020 should
be remitted as normal; due September 15, 2020.
Due
to the COVID-19 pandemic, a limited three-month cost report should also be
remitted for the period April 1, 2020 through June 30, 2020. This cost report
is also due September 15, 2020.
The
three-month limited cost report should include the following schedules:
- Information
- Schedule A
- Schedule A-1
- Schedule B
- Schedule D, Column 1 “Expense Per Gen. Ledger”
- Schedule J, signed and notarized
- Verification of Successful Submission from Medimax
In
addition, please submit the Medicaid grouped trial balance and the supplemental
attachment detailing sources of funding for the period April 1, 2020 through
June 30, 2020 to the three-month cost report as an electronic attachment.
The
cost reports will be submitted separately through Medimax.
Personal Protective Equipment (PPE)
Costs
related to personal protective equipment should be reported on Schedule D, Line
10-7, Medical Supplies and Expense.
COVID-19 Add-on Income and Expense Offset
Effective
for claims with Medicaid patient dates of service March 1, 2020 through the end
of the national emergency, there will be a $20.00 add-on to the per diem
payment for all nursing facilities due to the COVID-19 state of emergency.
For
the purposes of cost reporting, $20.00 x Total Medicaid Days for the period
March 1, 2020 through the end of the national emergency will be deemed
“COVID-19 Medicaid Income” and should be included on Schedule B, Line 1 and
detailed on Schedule COMMENTS.
COVID-19
Medicaid Income will be verified against actual provider payments and settled
after rate setting, if required.
COVID-19
Medicaid Income is to be offset against direct and indirect COVID-19 expenses
on Schedule D-3, Adjustments to Expense in the ratio of 75% direct (Schedule D,
Line 10-14) and 25% indirect (Schedule D, Line 45-7). These offsets will be
made during desk review before rate setting.
Per
usual, all invoices are subject to audit.
COVID-19 Add-on Income Received from Hospice Providers
Hospice
providers have pass-through contracts with nursing facilities to serve Medicaid
patients.
Hospice
income will continue to be reported on Schedule B, Line 3. The amount of
“COVID-19 Hospice Income” should be reported separately on Schedule COMMENTS.
Hospice
claims will be retroactively reviewed to determine if a settlement between the
COVID-19 Hospice Income reported on Schedule COMMENTS and the amount of income
paid through hospice claims is required.
COVID-19
Hospice Income is to be offset against direct and indirect COVID-19 expenses on
Schedule D-3, Adjustments to Expense in the ratio of 75% direct (Schedule D,
Line 10-14) and 25% indirect (Schedule D, Line 45-7). These offsets will be
made during desk review before rate setting.
COVID-19 Cleaning Fee Reimbursement
Medicaid
Cleaning Fee Reimbursements should be reported on Schedule B, Line 19,
Miscellaneous Income and detailed as “COVID-19 Cleaning Fee Reimbursement.”
Because
these fees are reimbursed outside of the per diem process similarly to NAT and
HepB, COVID-19 cleaning fees should be reported on Schedule D-4, Line 65-18.
These transactions will be reviewed during desk review before rate setting.
There
will be no income offset.
COVID-19 Communicative Technology
If
a facility was approved to use Civil Money Penalty (CMP) Reinvestment funds to
provide residents with adaptive communicative technologies, the funds should be
reported as Miscellaneous Income on Schedule B.
Devices
and accessories purchased with these funds are unallowable for Medicaid
reimbursement and should be included on Schedule D, Line 65-18.
There
will be no income offset.
Agency Contact
For questions regarding
this Alert, please contact Demetrius Bass, Associate Director of
QA/Reimbursement at Demetrius.Bass@medicaid.alabama.gov
or at (334) 353-4511.
Attachment to the 2020 Limited Three-Month Cost Report
Sources
of Funding
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