Current through Register Vol. 18, September 20, 2024
(1) Allowable costs will be determined in
accordance with generally accepted accounting principles as defined by the
American Institute of Certified Public Accountants.
(a) The department adopts and incorporates by
reference CMS Publication 15, which is a manual published by the United States
Department of Health and Human Services, Centers for Medicare and Medicaid
Services (CMS), which provides guidelines and policies to implement Medicare
regulations which set forth principles for determining the reasonable cost of
provider services furnished under the Health Insurance for Aged Act of 1965, as
amended. A copy of CMS Publication 15 may be obtained through the Department of
Public Health and Human Services, Health Resources Division, 1400 Broadway,
P.O. Box 202951, Helena, MT 59620-2951.
(b) For cost report periods occurring on or
after May 1, 2010, such definition of allowable costs is further defined in
accordance with the Medicare Provider Reimbursement Manual, CMS Publication 15,
Form 2552-10, subject to the exceptions and limitations provided in the
department's administrative rules.
(c) For cost report periods occurring prior
to May 1, 2010, such definition of allowable costs is further defined in
accordance with the Medicare Provider Reimbursement Manual, CMS Publication 15,
Form 2552-96, subject to the exceptions and limitations provided in the
department's administrative rules.
(d) For cost report periods ending January 1,
2006 through December 31, 2017, for each hospital which is a critical access
hospital, as defined in ARM
37.86.2901,
reimbursement for reasonable costs of inpatient and outpatient hospital
services shall be limited to 101% of allowable costs, as determined in
accordance with (1).
(e) For cost
report periods ending January 1, 2018 through June 30, 2018, for each hospital
which is a critical access hospital, as defined in ARM 37.86.2901,
reimbursement for reasonable costs of inpatient and outpatient hospital
services will be limited to 97.98% of allowable costs, as determined in
accordance with (1).
(f) For cost
report periods ending on or after July 1, 2018, for each hospital which is a
critical access hospital, as defined in ARM 37.86.2901, reimbursement for
reasonable costs of inpatient and outpatient hospital services will be limited
to 101% of allowable costs, as determined in accordance with (1).
(2) All hospitals reimbursed under
ARM
37.86.2806,
37.86.2905,
37.86.2907,
37.86.2912,
37.86.2916,
37.86.2918,
37.86.2920,
37.86.2924,
37.86.2925,
37.86.2928,
37.86.2943,
37.86.2947,
37.86.3005,
37.86.3006,
37.86.3007,
37.86.3009,
37.86.3014,
37.86.3016,
37.86.3018,
37.86.3020,
37.86.3022,
37.86.3025,
or
37.86.3109
must submit, as provided in (3), an annual Medicare cost report in which costs
have been allocated to the Medicaid program as they relate to charges. The
facility shall maintain appropriate accounting records which will enable the
facility to fully complete the cost report.
(3) All hospitals reimbursed under ARM
37.86.2806, 37.86.2905, 37.86.2907, 37.86.2912, 37.86.2916, 37.86.2918,
37.86.2920, 37.86.2924, 37.86.2925, 37.86.2928, 37.86.2943, 37.86.2947,
37.86.3005, 37.86.3006, 37.86.3007, 37.86.3009, 37.86.3014, 37.86.3016,
37.86.3018, 37.86.3020, 37.86.3022, 37.86.3025, or 37.86.3109 must file the
cost report with the Montana Medicare intermediary and the department on or
before the last day of the fifth calendar month following the close of the
period covered by the report. For fiscal periods ending on a day other than the
last day of the month, cost reports are due 150 days after the last day of the
cost reporting period.
(a) Extensions of the
due date for filing a cost report may be granted by the intermediary only when
a provider's operations are significantly adversely affected due to
extraordinary circumstances over which the provider has no control.
AUTH:
53-2-201,
53-6-113,
MCA; IMP:
53-2-201,
53-6-101,
53-6-111,
53-6-113,
53-6-149,
MCA
