NYS INSTITUTIONAL COST REPORT SEMINAR

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NYS INSTITUTIONAL COST REPORT SEMINAR

• HFMA SESSIONS
• March 30 April 3, 2009
• John W. Gahan Jr.
• Dennis Kling
• Jane Casale
• Tami Berdi

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Introduction

• ICR
• Additions
• Modifications
• Friendly reminders from your rate analysts
• Provider Assistance
• Filing Procedures
• HPN
• Uses of ICR Data
• 2009 Rates
• Questions and Answers

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Additions

• Cost Center Matrix
• Transitional Care Unit cc 317
• Exhibits 32 and 33
• Payments collected for uninsured patients
• Section 2807-k5-a(c)
• Uninsured/Self Pay
• Free (Charity, Hill-Burton)

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ADDITIONS CONT

• Exhibit 50
• Addition of Appeals columns for submitted,
  approved, and denied appeals

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Modifications

• Importing of Prior Years Cost Centers
• Exhibit 29 Notes to the Audited Financial
  Statements
• Importing pdf file
• Additional section of 400 lines

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Friendly reminders from your rate analysts

• New DOH website
• www.nyhealth.gov
• Cost Center Set-Up
• Delete Unused Cost Centers
• Exhibit 50
• Zip Codes entered for Question 4 should be
  limited to 5 digits, with no text or 4 digit
  extensions added
• FAQs are available on the HPN specific to this
  exhibit

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Provider Assistance

• DOH to provide overall coordination and support
• Check FAQs on the HPN
• Instructions added to the HPN
• E-mail address bpacr_at_health.state.ny.us
• Analyst assigned to your facility

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Provider Assistance (Cont)

• Medicare Questions and Issues
• Completion of 2552
• Medicare Settlement Manager
• Software Question
• DOH via bpacr_at_health.state.ny.us
• Blue Cross Plans
• Contact your local plan

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Filing Procedures

• Due Date June 1, 2009
• Submission to DOH
• DH file (June 1, 2009)
• Hardcopy (5 business days later)
• Report (Including certifications)
• 2 copies of Audited Financial Statements
• Edits

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Health Provider Network

• Keep current
• Add new employees
• Coordinator
• All forms available to the coordinator on the HPN
• Consult the Communications Directory under the
  HPN website for a guide on how to remove users
• Bureau email for HPN issues only
• bpacrhpn_at_health.state.ny.us

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ICR Data Used for Many Things!!

• ICR data not used only for rate setting
• Medicaid Reform for inpatient and outpatient
  services
• Developing models for cost containment and
  revised methodologies
• Basis for reimbursement
• RCC - Rebasing
• 2007 RCC this spring

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ICR Data Used for Many Things!! (cont)

• Indigent Care Reform
• Current Method uses accounting methodology to
  determine uncompensated care
• 2008 2009 budget modified that based in part on
  recommendations from the Technical Advisory
  Committee Report
• 2009 Pools
• 10 will be based on units of service and the
  Medicaid rates
• 90 will be based on the current methodology
• 2007 uninsured units of service
• 2007 ICR Exhibits 32 and 33
• 2007 Medicaid inpatient rates without prospective
  adjustments, HCRR, and legislative add-ons
• 2009 Medicaid average APG rate for outpatient

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INDIGENT CARE REFORM (CONT)

• Exhibits 32 and 33 data critical
• Uninsured categories as reported on 2007 ICR
• Uninsured/Self-pay
• Free (Charity, Hill Burton)
• Collections to be offset starting in 2010
• Direct Write off method to be used in 2008 ICR

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2009 Rates (1/1/2009 6/30/2009)

• Normal Items
• 2008 2009 Trends Depends on budget actions
• 2007 final capital
• 2009 budgeted capital
• 2007 volume adjustments
• Also to be reflected
• Legislative add-ons that are continued into 2009
• Pending CMS approval
• New SIWS for 2009
• Phase 2 66 new/33 old
• Adopted by SHRPC and posted to DOH web
• www.nyhealth.gov
• Worker Retention
• Pending CMS approval for 2008-2009 fiscal year
  (ends 3/31/2009)

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