Interim Reconciliation. Each FQHC-LA's uncompensated care costs must be recomputed based on the actual as-filed cost report for the actual service period. The cost report is filed with AHCCCS covering the federal fiscal year (ending September 30) by April of the following year. SNCP uncompensated care payments made to the FQHC-LA for a DY cannot exceed the recomputed uncompensated care cost limit. If, at the end of the interim reconciliation process, it is determined that expenditures claimed exceeded the individual clinic's uncompensated care cost limit, the overpayment will be recouped from the clinic, and the federal share will be properly credited to the federal government. The interim reconciliation follows the same computation as outlined above in the Interim Computation of Uncompensated Care Costs steps, except that: - The cost per visit is computed based on allowable FQHC-LA cost and total visits pertaining to the actual service period cost report. - Both Medicaid visits and uninsured visits furnished during the service period are applied to the actual cost per visit to determine the clinic's Medicaid and uninsured costs. Medicaid and uninsured visits must be derived from auditable sources, including the State's PMMIS, managed care encounter data, and provider patient accounting records. - Both Medicaid and uninsured revenues, applicable to actual service period and derived from auditable sources, are offset against Medicaid and uninsured costs to arrive at the clinic's uncompensated care costs. - No trending factor will be applied. The uncompensated care costs must again be adjusted to remove costs related to non-emergency services furnished to unqualified aliens. An FQHC-LA's uncompensated care cost limit is determined for the twelve month period in each DY, except for DY 3 in which the uncompensated care cost limit is computed for the three month period ending December 31, 2013. Where a clinic's cost reporting period does not coincide with the DY (or partial DY in DY3), the uncompensated care costs computed for a cost reporting period can be allocated to the DY (or partial DY) based on the number of cost reporting months that overlap with the DY (or partial DY). The interim reconciliation described above will be performed and completed within six months after the filing of the FQHC-LA cost report(s).
Interim Reconciliation. Within 12 months of the provider’s cost report filing for each reporting year, the Commonwealth must validate cost data using the CMS-approved cost limit protocol, developed jointly by Massachusetts and CMS. Interim Reconciliation will be based on the results of the Commonwealth’s review. Any increasing or decreasing adjustment identified as a result of the settlement must be reported to CMS as an adjustment to reported expenditures and reported through the CMS-64 process.
Interim Reconciliation. Within 12 months of the provider’s cost report filing for each reporting year, the Commonwealth must validate cost data using the CMS-approved cost review protocol, developed jointly by Massachusetts and CMS. Interim Reconciliation will be based on the results of the Commonwealth’s review. Any increasing or decreasing adjustment identified as a result of the settlement must be reported to CMS as an adjustment to reported expenditures and reported through the CMS-64 process. Final Reconciliation – For each provider subject to cost settlement, the Commonwealth must complete final settlement within 12 months after the provider’s final and audited (as applicable) cost report become available. The Commonwealth must submit cost and payment information for that demonstration year as required by the CMS-approved cost limit protocol. Any increasing or decreasing adjustment identified as a result of the settlement must be reported to CMS as an adjustment to reported expenditures and reported through the CMS-64 process. CMS will complete its review of the costs reported using the protocol tool and send concurrence or share its findings with the Commonwealth within 120 calendar days of receipt. Standard Medicaid Funding Process. The standard Medicaid funding process must be used during the demonstration. Massachusetts must estimate matchable demonstration expenditures (total computable and federal share) subject to the budget neutrality expenditure limit and separately report these expenditures by quarter for each FFY on the Form CMS-37 (narrative section) for both the Medical Assistance Payments (MAP) and State and Local Administrative Costs (ADM). CMS shall make federal funds available based upon the state’s estimate, as approved by CMS. Within 30 days after the end of each quarter, the state must submit the Form CMS-64 quarterly Medicaid expenditure report, showing Medicaid expenditures made in the quarter just ended. CMS shall reconcile expenditures reported on the Form CMS-64 with federal funding previously made available to the state, and include the reconciling adjustment in the finalization of the grant award to the state.
Interim Reconciliation. Each provider's uncompensated care costs must be computed based on the provider's as-filed CMS 25525 cost report and Uniform Medicaid & Uncompensated Care Cost & Charge Report (UCCR) and for the actual service period. The CMS 2552 cost report is filed with the Medicare contractor five months after the close of the cost reporting period. The UCCR must be filed three months after the CMS 2552 is filed. For SNCP payments subject to the cost limit pursuant to STC 49(c), each provider’s allowable Medicaid, uncompensated care, and uninsured costs must be reconciled against associated applicable payments received for the year for which the payments were made. For hospitals whose accounting fiscal year aligns with the cost limit reporting fiscal year (Federal fiscal year), the Medicaid and uninsured costs will be reflected in the CMS 2552 and UCCR that is submitted for the accounting fiscal year. For acute hospitals whose accounting fiscal years do not align with the reporting fiscal year, the reporting year cost limit will be calculated by applying the appropriate percentage of the two contiguous CMS 2552 and UCCR cost reports that span the reporting fiscal year so that the Federal fiscal year will be represented in the cost limit calculation. The Commonwealth must recover provider overpayments as it determines necessary based on its reconciliation calculations and availability of federal financial participation. Specifically, if an overpayment exists, the Commonwealth must determine if the overpayment occurred due to Health Safety Net (HSN) Trust Fund payments or other SNCP payments, or from both payments. To the extent that the overpayment is a result of overpaid funds from the HSN Trust Fund, the Commonwealth must recover from the provider the amount overpaid to the provider from the HSN Trust Fund and credit that amount to the HSN Trust Fund. The HSN Trust Fund will redistribute such amounts to other providers as appropriate. To the extent that the overpayment is not 5 Community Based Detoxification Centers are the only provider type subject to the cost limit that does not submit the CMS 2552 cost report. Massachusetts MassHealth Section 1115 Demonstration Safety Net Care Pool Uncompensated Care Cost Limit Protocol December 11, 2013 the result of HSN Trust Fund payments, the Commonwealth must recover from the provider the overpayment, and the Commonwealth must properly credit the federal share to the federal government. The interim reconciliation described ab...
Interim Reconciliation. In addition to the final reconciliation (13) months after the close of any contract year, interim reconciliations and payments based thereon shall be made upon the following schedule: ------------------------------------------------------------------------------------------------------------- Surplus Payment For the Contract Reconciliation Report % of Surplus or Distribution Date Period Date Deficit Paid to or by PIC at the Distribution Date ------------------------------------------------------------------------------------------------------------- November 5, 1997 3/1/97 - 6/30/97 10/97 Paid Thru 9/97 60% ------------------------------------------------------------------------------------------------------------- February 15, 1998 3/1/97 - 6/30/97 1/98 Paid Thru 12/97 90% 7/1/97 - 9/30/97 60% ------------------------------------------------------------------------------------------------------------- May 15, 1998 3/1/97 - 6/30/97 4/98 Paid Thru 3/98 100% 7/1/97 - 9/30/97 90% 10/1/97 - 12/31/97 60% ------------------------------------------------------------------------------------------------------------- August 15, 1998 3/1/97 - 6/30/97 Final 7/98 Paid Thru 6/98 100% 7/1/97 - 9/30/97 100% 10/1/97 - 12/31/97 90% 1/1/98 - 3/31/98 60% ------------------------------------------------------------------------------------------------------------- November 15, 1998 7/1/97 - 9/30/97 10/98 Paid Thru 9/98 100% 10/1/97 - 12/31/97 100% 1/1/98 - 3/31/98 90% 4/1/98 - 6/30/98 60% ------------------------------------------------------------------------------------------------------------- February 15, 1999 10/1/97 - 12/31/97 1/99 Paid Thru 12/98 100% 1/1/98 - 3/31/98 100% 4/1/98 - 6/30/98 90% 7/1/98 - 9/30/98 60% ------------------------------------------------------------------------------------------------------------- May 15, 1999 1/1/98 - 3/31/98 4/99 Paid Thru 3/99 100% 4/1/98 - 6/30/98 100% 7/1/98 - 9/30/98 90% 10/1/98 - 12/31/98 60% ------------------------------------------------------------------------------------------------------------- August 15, 1999 7/1/97 - 6/30/98 Final 7/99 Paid Thru 6/99 100% 7/1/98 - 9/30/98 100% 10/1/98 - 12/31/98 90% 1/1/99 - 3/31/99 60% ------------------------------------------------------------------------------------------------------------- Thereafter Quarterly According to the Above Schedule of Quarterly and Final Annual Reconciliations If after an interim surplus or deficit distribution is made it is determined that the distr...
Interim Reconciliation. Subsequent to June 19, 2008, and prior to September 1, 2008 (i.e., the first anniversary of the Project Commencement Date), Landlord expended that portion of the Pending Accruals (the “Interim Expenditure”) more particularly identified on Exhibit B, attached hereto and made a part hereof. Landlord and Tenant hereby acknowledge and agree that, as identified above, such Interim Expenditure has now been reconciled into the Project Costs as of September 1, 2008, the resulting recalculation of Base Rent has been made effective as of September 1, 2008 (as set forth in Section 5, below).
