Current through September 24, 2024
A. Participating Mississippi intermediate
care facilities for individuals with intellectual disabilities (ICF/IIDs) must
prepare and submit a Long-term Care Medicaid cost report for reimbursement.
1. All cost reports are due by the end of the
fifth (5th) calendar month following the reporting period.
2. Failure to file a cost report by the due
date or the extended due date will result in a penalty of fifty dollars
($50.00) per day and may result in the termination of the provider
agreement.
B. The
Division of Medicaid uses a prospective method of reimbursement.
1. The rates are calculated from cost report
data.
2. The rates are calculated
annually with an effective date of January first (1st).
3. In no case may the reimbursement rate for
services provided exceed an individual ICF/IID's customary charges to the
general public for such services in the aggregate, except for those public
facilities rendering such services free of charge or at a nominal
charge.
4. Prospective rates may be
adjusted by the Division of Medicaid pursuant to changes in federal and/or
state laws or regulations.
5.
Prospective rates may be adjusted by the Division of Medicaid based on
revisions to allowable costs or to correct errors.
a These revisions may result from amended
cost reports, audits, or other corrections.
b Facilities are notified in writing of
amounts due to or from the Division of Medicaid as a result of these
adjustments.
c There is no time
limit for requesting settlement of these amounts. This is applicable to claims
for dates of service since July 1, 1993.
C. The Division of Medicaid conducts periodic
cost report financial reviews of selected ICF/IIDs to verify the accuracy and
reasonableness of the financial and statistical information contained in the
Medicaid cost reports. Adjustments will be made as necessary to the reviewed
cost reports based on the results of the reviews.
D. Notwithstanding any other provision of
this article, it shall be the duty of each ICF/IID that is participating in the
Medicaid program to keep and maintain books, documents and other records as
prescribed by the Division of Medicaid in substantiation of its cost reports
for a period of three (3) years after the date of submission to the Division of
Medicaid of an original cost report, or three (3) years after the date of
submission to the Division of Medicaid of an amended cost report.
1. Providers must maintain adequate
documentation including, but not limited to, financial records and statistical
data, for proper determination of costs payable under the Medicaid program.
a The cost report must be based on the
documentation maintained by the ICF/IID.
b All non-governmental ICF/IIDs must file
cost reports based on the accrual method of accounting.
c Governmental ICF/IIDs have the option to
use the cash basis of accounting for reporting.
2. Documentation of financial and statistical
data should be maintained in a consistent manner from one period to another and
must be current, accurate and in sufficient detail to support costs contained
in the cost report.
3. Providers
must make available to the Division of Medicaid all documentation that
substantiates the information included in the ICF/IID cost report for the
purpose of determining compliance.
a These
records must be made available as requested by the Division of
Medicaid.
b All documentation which
substantiates the information included in the cost report, including any
documentation relating to home office and/or management company costs, must be
made available to Division of Medicaid reviewers as requested by the
Division.
42 C.F.R.
§ 447, Subparts B and C; Miss. Code Ann. §§
43-13-117,
43-13-121.
