Audit
The Audit area performs desk reviews and audits of Medicare cost reports, including S-10 and wage index and occupational mix reviews, issues the Notice of Program Reimbursement (NPR), and processes cost report reopenings and appeals.
|
Wage Index and Occupational Mix |
The wage index for all eligible short-term acute IPPS hospitals are reviewed annually. Every three years, data are collected and reviewed on the occupational mix of employees for each short-term, acute care hospital. |
Email us at: |
|---|---|---|
|
S-10 Audits |
Providers eligible for Disproportionate Share Hospital Uncompensated Care Payment (DSH UCP) are subject to an audit of data reported on worksheet S-10 of the Medicare cost report. |
Email us at: |
|
Desk Review and Audit |
Medicare cost reports are subject to reviews to determine the adequacy, completeness and reasonableness of the data reported. Based on initial review findings, cost reports may be subject to in-house or field audits. |
Email us at: JJCostReport@palmettogba.com |
| Volume Decrease Adjustment |
A volume decrease adjustment (VDA) may be requested no later than 180 days after the date of the NPR for that cost report, if the following conditions are met:
Requests must be in writing and supporting documentation must be submitted with the volume decrease adjustment request. |
Email us at: JJAudit.Reopening@palmettogba.com For more information: |
|
Reopenings |
A reopening of a cost report may be requested within three years of the NPR if the following conditions are met:
Requests must be in writing and supporting documentation must be submitted with the reopening request. |
Email us at: JJAudit.Reopening@palmettogba.com |
|
Appeals |
Providers have the right to appeal cost report review determinations. An appeal of a cost report issue can be requested, within 180 days of the NPR, through the electronic filing system, Office of Hearings Case and Document Management System (OH CDMS) located at https://portal.cms.gov/ . |
Email us at: JJAudit.Appeal@palmettogba.com |
|
General Information |
Stay Up-to-Date on the Latest Medicare Audit and Reimbursement Information |
|