Oregon Administrative Rules › Chapter 309 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: BEHAVIORAL HEALTH SERVICES › Division 15 - MEDICAID PAYMENT FOR PSYCHIATRIC HOSPITAL INPATIENT SERVICES › Section 309-015-0045 - Filing of Annual Medicaid Cost Report

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Timing of report. The provider shall file
			 annually with the Medicaid Intermediary, an annual Medicaid cost report
			 covering actual costs based on the latest fiscal period of operation of the
			 facility. If the provider has separate cost entities or distinct programs, an
			 annual Medicaid cost report shall be filed for each entity. A Medicaid cost
			 report will be filed for less than an annual period only when necessitated by
			 facilities terminating their agreement with the Division, or by a change in
			 ownership, or by a change in fiscal period. The provider is to use the same
			 fiscal period for the Medicaid cost report as that used for the Medicare cost
			 report and the federal tax return. The Medicaid cost report is due within 90
			 days of the end of the normal fiscal period, change of ownership, or withdrawal
			 from the program except when Medicare grants an extension of the Medicare cost
			 report (upon which the Medicaid cost report relies). In that case, the due date
			 for the Medicaid cost report may be extended by the Medicaid Intermediary for
			 the same number of days as the due date for the Medicare cost report.
(2) Contents of report. The annual Medicaid
			 cost report is a uniform cost report containing an itemized list of allowable
			 costs to be used by all providers. It shall report the hospital's actual
			 financial data and be completed in accordance with instructions provided by the
			 Medicaid intermediary.
(3)
			 Application of Medicare principles of reimbursement. Providers filing annual
			 Medicaid cost reports with the Medicaid Intermediary shall apply Medicare
			 principles of reimbursement.
(4)
			 Signature. Each required annual Medicaid cost report shall be signed by the
			 individual who normally signs the provider's federal income tax return or other
			 reports. If the report is prepared by someone other than an employee of the
			 provider, the individual preparing the report shall also sign and indicate his
			 or her status with the provider.
(5) Improperly completed reports. The
			 Medicaid Intermediary shall return improperly completed or incomplete annual
			 Medicaid cost reports to the provider for proper completion. All providers
			 shall return corrected or completed reports to the Division within 30 days or
			 become subject to the same penalty as for failure to submit the cost
			 statement.
(6) Reduction of interim
			 per diem rate - Late reports. If the original submission of the Medicaid cost
			 report is not made within the required 90-day time period or extended period
			 (see section (1) of this rule), the interim per diem rate then in effect will
			 be reduced to 80 percent of the hospital's current interim per diem rate or the
			 rate established from the last audited or desk reviewed cost statement,
			 whichever is lower. This rate will remain in effect until submission of the
			 Medicaid cost report.
(7)
			 Late-billed services. If a hospital bills for services provided during a fiscal
			 period for which the hospital has submitted an annual Medicaid cost report, the
			 days which are late-billed may be included in the hospital's next fiscal
			 period.
(8) False reports. If a
			 provider knowingly, or with reason to know, files a report containing false
			 information, such action constitutes cause for termination of its agreement
			 with the Division. Providers filing false reports may be referred for
			 prosecution under applicable statutes (see OAR
			 309-015-0052).
(9) Maintenance of report. The Medicaid
			 Intermediary shall maintain each required annual Medicaid cost report submitted
			 by a provider for three years following the date of submission. In the event
			 there are audit questions, the cost statement shall be maintained for three
			 years after the final audit settlement.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  414.025 &
				  414.065