Cost Report Submission Requirements

The official language

All providers required to file a Cost Report are required to submit a Cost Report within 5 months of the Cost Reporting fiscal year end or 30 days after a valid PS&R is sent to the provider by the intermediary, whichever is later. If the provider fails to submit a Cost Report timely or if the Cost Report is rejected, payments to the provider are reduced and a demand letter will be issued for previous payments.

All providers, with the exception of Outpatient Physical Therapy Providers and Comprensive Outpatient Rehabilitation Facilities are required to file an annual Medicare Cost Report.

The Cost Report forms including the CMS 339 and all instructions needed to properly fill out the forms can be obtained by visiting the CMS web site.

Most providers must now file their Cost Report electronically using an approved vendor's software. Please see the electronic filing requirements.

If the Cost Report due date falls on a weekend, National or National Government Services, Inc Holiday, the due date is extended to the next business day.

You may also obtain a copy of the Provider Statistical and Reimbursement Report (PS&R).

An acceptable Medicare Cost Report includes all of the items below for all providers filing Electronic Cost Reports (ECRs):

1. A diskette of the ECR utilizing a CMS-approved vendor with the current specification date submitted.
   
2. An ECR that passes all Level 1 edits.
   
3. A submitted print image file of the Cost Report except when using CMS free software.
   
4. The certification page (Worksheet S) of the ECR file with the actual signature of an officer (administrator or chief financial officer).
   
5. An exact match of the encryption code, date and time for the ECR displayed on the certification page to that of the ECR file encryption code, date and time.
   
6. An exact match of the encryption code, date and time for the print image displayed on the certification page to that of the print image file encryption code, date and time except when using CMS free software.
   
7. For teaching hospitals, a complete Intern and Resident Information System (IRIS) diskette that will pass all IRIS system edits.
   
8. The settlement summary on the electronic certification page agrees with the settlement summary on the Medicare Cost Report produced from the electronic file.
   
9. A completed, signed and submitted Form CMS-339 with an original signature.

FROM ALL OTHER PROVIDERS

1. A completed and legible Cost Report on the proper forms.
   
2. A general information and certification page which includes the original signature of an officer (administrator or chief financial officer).
   
3. A completed, signed and submitted Form CMS-339 with an original signature.

Additionally, the following items (1-6), where appropriate, must be submitted with the provider’s Cost Report.

1. Correctly updated graduate medical education (GME) per resident amounts.
   
2. All applicable documentation required per Form CMS-2552-96
   
3. All required documentation per Form CMS-339.
   
4. A copy of the working trial balance.
   
5. A copy of the audited financial statements where applicable.
   
6. Where applicable, the supporting documentation for reclassifications, adjustments, related organizations, contracted therapists, and protested items.

NOTE: Home office cost statements are to be submitted within 150 days of the Chain Home Office’s fiscal year’s end. If the Chain Home Office fails to submit a cost statement within that time frame, the Chain Home Office will be notified of its failure to submit a cost statement and the servicing intermediaries to issue a demand notice requiring repayment of Home Office Costs. The servicing intermediaries are required to reduce interim payments to the providers to reflect the disallowance of any Home Office costs.

Are you looking for an alternative to the time consuming practice of preparing a Cost Report? You may be eligible to file less than a full Cost Report due to low Medicare utilization. Find out more.

BCA Training Booklets

Cost Report FILING INSTRUCTIONS

Helpful Hints

1. Your Medicare Cost Report is due 150 days after your fiscal year end whether you are an active provider, terminated, or you experienced a change of ownership. The 150 days apply whether or not you received official notification from NGS.
2. To help you prepare your Cost Report accurately, and prevent the rejection and suspension of payments, we have prepared the following generic steps that you should follow prior to submitting your Medicare Cost Report for processing.

   a. Make sure your cost report is complete, with all applicable worksheets.

   b. Make sure the certification page of your Cost Report and the CMS 339 is signed with an original signature from an officer of your facility.
   
   c . Staple the supporting documents for your reclassifications and adjustments in Cost Report order
   
   d . Make sure that all-previous Cost Report audit adjustments for non-allowable Medicare costs are incorporated into this Cost Report. If you wish to protest the prior year adjustments, you must remove amounts from the Cost Report and add them to the protested line on the Cost Report. Also, include the details and computations of program effect of protested items
   
   e . Enclose the CMS 339 with all attachments. Staple the attachments to the CMS 339 and cross-reference each attachment to the specific question in the CMS 339. You must use the official version of the form, or one approved by CMS for your vendor. We DO NOT accept typed or non-approved automated versions of the CMS 339.
   
   f . With a teaching hospital Cost Report, you need to submit the IRIS diskette after running the IRIS edit program and ensured all edits are cleared. (IRIS EDV3)
   
   g . Enclose the detailed working trial balance.
   
   h . Include one copy of the Financial Statement, if available. If not available at the time of filing, indicate that fact on the CMS 339 and mail it in when available.
   
   i . If you are submitting a Home Office Cost Statement, please mail it in a separate package.
   
   j . If the Cost Reports, CMS-339 and trial balances are sent for more than one provider in the same package, please indicate this fact on the top of the package to avoid oversight.
   
   k . Under the current regulations, NGS is not allowed to accept postage from a meter postage machine unless accompanied with a postmark date from the United States Postal Service (U.S.P.S.). For Cost Reports with a postage meter reading and no U.S.P.S. postmark is on the package, at CMS' direction, we will use a postmark date equal to our NGS receipt date.

3. Submit your Cost Report at least a week early to take advantage of the grace period. The grace will minimize the risk of payment suspension or interest charges. Per PM-II P. 130.4, the grace period is based on the day received and not the post mark date.

PENALTIES FOR LATE FILING

In the event you fail to timely file an acceptable Cost Report with all required information such as the CMS- 339, Medicare payments will be suspended until a Cost Report is filed and determined to be acceptable. See 42 C.F.R. § 405.371 (C). Interim payments advanced for the period are considered overpayments.

If your Cost Report indicates an overpayment, the amount due should be mailed to the appropriate Lock Box with a copy of the check sent along with the Cost Report. If this is not possible because of a financial hardship, please submit a repayment proposal and supporting financial data. If full payment or an extended repayment plan (ERP) is not submitted with the Cost Report, interim payments will be suspended upon receipt of the Cost Report. If no payment arrangements are made as indicated above, our provider payment department will send you a demand letter requesting payment of the amount due. The demand letter will indicate that interest will begin accruing from the day after the cost report is due and is calculated in 30-day increments for each full 30-day period until the cost report is filed and accepted. In addition, failure to file a Cost Report will result in a referral to the Department of Justice for collection as well as possible termination from the Medicare Program.

If the Cost Report is rejected, it is deemed unacceptable and treated as if never filed. Specifically, as is mentioned above, if an acceptable Cost Report is not submitted timely, a suspension of payments will be imposed. Accordingly, when a Cost Report is filed timely but is rejected and thereby deemed unacceptable, a suspension of payments will be implemented under the provisions of 42 C.F.R. § 405.371 (C). In addition, in this situation, and in the situation where a Cost Report is not filed timely, interim payments for the period will be considered overpayments until an acceptable Cost Report is filed.