Alabama Administrative Code › Title 560 - ALABAMA MEDICAID AGENCY › Chapter 560-X-42 - ICF/MR REIMBURSEMENT › Section 560-X-42-.20 - Cost Reports

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Extensions.
			 Each provider is required to file a complete uniform cost report for each
			 fiscal year ending September 30th. The complete uniform cost report must be
			 received by Medicaid on or before November 30th. Should November 30th fall on a
			 state holiday or weekend, the complete uniform cost report will be due the next
			 working day. Cost reports shall be prepared with due diligence and care to
			 prevent the necessity for later submittals of corrected or supplemental
			 information by ICF/IID facility. Extensions may be granted only upon written
			 approval by Medicaid for good cause shown. An extension request must be in
			 writing, contain the reasons for the extension, and must be made prior to the
			 cost report due date. Only one extension per cost reporting year will be
			 granted by the Agency.
(2)
			 Penalties. If a complete uniform cost report is not filed by the due date, or
			 an extension is not requested or granted, the provider shall be charged a
			 penalty of one hundred dollars per day for each calendar day after the due
			 date; this penalty will not be a reimbursable Medicaid cost. The Commissioner
			 of Medicaid may waive such penalty for good cause shown. Such showing must be
			 made in writing to the Commissioner with supporting documentation. Once a cost
			 report is late, Medicaid shall suspend payments to the provider until the cost
			 report is received. A cost report that is over ninety (90) days late may result
			 in suspension of the provider from the Medicaid program. Further, the entire
			 amount paid to the provider during the fiscal period with respect to which the
			 report has not been filed will be deemed an overpayment. The provider will have
			 thirty (30) days to either refund the overpayment or file the delinquent cost
			 report after which time Medicaid may institute a suit or other action to
			 collect the overpayment amount.
(3)
			 Each uniform cost report will be signed by the provider, and if the cost report
			 is prepared by anyone other than the provider or a full-time employee of the
			 provider, such person shall execute the report as the Cost Report Preparer. The
			 signatures of both the provider and Cost Report Preparer, if any, must be
			 preceded by the following certification: I HEREBY CERTIFY that I have read the
			 above statement and that I have examined the accompanying Cost Report and
			 supporting schedules prepared on behalf of
			 _______________________________________________ Provider name(s) and number(s)
			 for the cost report period beginning
			 _______________________________________________ and ending
			 ____________________________ and that to the best of my knowledge and belief,
			 it is a true, correct and complete report prepared from the books and records
			 of the provider(s) in accordance with applicable Medicaid Reimbursement
			 Principles, except as noted.
Signed ___________________________
Officer or Administrator of Provider(s)
______________________
Cost Report Preparer
By: ________________________ Title
				_________________________
Date _______________________ Date
				_________________________
(4) Any cost report received by Medicaid
			 without the required original signatures and/or without the required
			 certification(s) will be deemed incomplete and returned to the
			 provider.
(5) Cost reports will be
			 deemed immutable with respect to the reimbursement for which the provider is
			 entitled for the next succeeding fiscal year, one year from the date of its
			 receipt by Medicaid, or its due date, whichever is later. Providers will have
			 this one year period within which to resubmit their cost reports for the
			 purpose of correcting any material errors or omissions of fact. This one year
			 limitation does not apply to adjustments in cost reports that are initiated by
			 Medicaid. Medicaid retains the right to make adjustments in cost reports at any
			 time a material error or omission of fact is discovered.
(6) Providers who terminate their
			 participation in the Medicaid Program, by whatever means, must provide a
			 written notice to the Agency thirty (30) days in advance of such action.
			 Failure to provide this written notice shall result in a one hundred dollar
			 ($100) per day penalty being assessed for each day short of the 30 day advance
			 notice period (up to a maximum of $3,000). Terminating providers must file a
			 final cost report within sixty (60) days of terminating their participation in
			 the program. Final payment will not be made by the Medicaid Agency until this
			 report is received. Failure to file this final cost report will result in
			 Medicaid deeming all payments covered by the cost report period as overpayments
			 until the report is received. Additionally, a penalty of one hundred dollars
			 ($100) will be assessed for each calendar day that the cost report is late.
			 [See Rule 56O-X-42-.20(2).]
(a) Terminating
			 cost reports which are audited by the Agency will be subject to retroactive
			 adjustment. This adjustment (if applicable) will either be paid or recouped by
			 a lump sum payment.