Ohio Administrative Code › Title 5160 - Ohio Department of Medicaid › Chapter 5160-2 - Hospital Services › Section 5160-2-23 - Cost reports

Current through all regulations passed and filed through July 1, 2024
(A) For cost-reporting purposes,
			  each eligible
			 provider, as defined in rule
			 5160-2-01 of the Administrative
			 Code, is to submit periodic reports that
			 generally cover a consecutive twelve-month period of the provider's operations.
			 Failure to submit all necessary items and schedules will delay processing and
			 may result in a reduction of payment or termination as a provider as described
			 in paragraph (A)(7) of this rule.
Any hospital that fails to submit cost reports on or
				before the dates specified by the department of medicaid (ODM)
									will be
				fined one thousand dollars for each day after the due date that the information
				is not reported.
The hospital is to complete and submit the ODM 02930 "Ohio Medicaid
				Hospital Cost Report" that is applicable to the state fiscal year in which the
				hospital's cost reporting period ends. The hospital's cost report
				is
				to:
(1) Be prepared in
			 accordance with medicare principles governing reasonable cost reimbursement set
			 forth in the providers' reimbursement manual "CMS Publications, 15-1 and 15-2",
			 as applicable to the hospital's reporting period.
(2) Include all information necessary for the
			 proper determination of costs payable under medicaid, including financial
			 records and statistical data.
(3)
			 Be submitted in accordance with the cost report instructions and include an
			 electronic copy of the medicare cost report, which is to be
			 identical in all respects to the cost report submitted to the medicare fiscal
			 intermediary.
(4) Include the cost
			 report certification executed by an officer of the hospital attesting to the
			 accuracy of the cost report and to the accuracy of the
			 Omnibus Budget
			 Reconciliation Act (OBRA) survey. In addition, all subsequent revisions
			 to the cost report are to include an executed certification.
(5)
									The executed certification is to
									include an
			 acknowledgement by the officer of the hospital  that an independent, certified
			 public accountant has successfully
			 verified the data reported on "Schedule F" of the cost report in accordance
			 with the procedures included in the cost report instructions. In addition, all
			 subsequent revisions to "Schedule F" are also
			 to be successfully verified by an independent,
			 certified public accountant in accordance with the recertification procedures
			 included in the cost report instructions.
(6) For hospital reporting periods ending
			 between January first and June thirtieth the cost report
			 is to be
			 postmarked on or before December thirty-first of the same calendar year. For
			 hospital reporting periods ending between July first and December thirty-first,
			 the cost report is to be postmarked on or before June thirtieth of the
			 following calendar year.
(a) Extensions may be
			 granted as specified in the cost report instructions.
(b) The department may grant a blanket
			 extension that affects one or both of the due dates described in paragraph
			 (A)(6) of this rule. When the department grants a blanket extension, hospitals
			 may still request an extension as specified in paragraph (A)(6)(a) of this
			 rule.
(7) Hospitals that
			 fail to submit cost reports timely as described in paragraph (A) of this rule
			 will receive a delinquency letter from ODM and are subject to notification that
			 thirty days following the date on which the cost report was due, payments for
			 hospital services will be suspended. Suspension of payments will be terminated
			 on the fifth working day following receipt of the delinquent cost report. At
			 the beginning of the third month following the month in which the hospital cost
			 report became overdue, if the cost report has not yet been submitted,
			 termination of the provider from the program will be proposed in accordance
			 with Chapter 5160-1 of the Administrative Code.
(8) Hospitals are to
			 separately report all supplemental payments received for services provided
			 during the cost report period, including;
(a)
										"Medicaid Managed
			 Care Incentive Payments," as established by Section 309.30.33 of Amended
			 Substitute House Bill 153 of the 129th General Assembly, and continued as a
			 baseline program, and
(b)
										"Hospital Additional Payments," as established by
			 Section 16 of Amended Substitute Senate Bill 310 of the 133rd General Assembly
			 and continued in Section
			 333.45 of Amended Substitute
			 House Bill 110 of the 134th General Assembly.