Skip to content

Pete Harmon's HFS Blog

Health Financial Systems – Director, Government Relations

In my earlier Posts (and our web site, www.hfssoft.com), I had FY Begin and FYE 10/1/2009, for the effective date of T.17.  This is to clarify that the SNF T.17 is effective for FY END 10/1/2009 and after (i.e. MUST be used for this FYE).  Also, CMS rescinded the change to S-2 line 20, to require an answer of F/L/N for a Full, Low, or No Medicare Utilization report.  S-2 line 20 reverts back to T.16, where you ONLY complete it with an L or N, for Low/No utilization.  If it is a Full report, line 20 is left Blank.

HFS recently received approvals for the Hospital 2552-96, Transmittal 21 (our version 21.0.119.0), which we posted 3/12/2010; SNF 2540-96, Transmittal 17 (our version 17.0.119.0); HHA 1728-94, Transmittal 14/15 (our version 15.0.119.0); and RHC/FQHC 222-92, Transmittal 8/9 (our version 9.0.119.0).  All of these MUST be used for cost reports with FYE on or after 10/1/2009.  We expect to post the SNF, HHA, and RHC/FQHC updates this week (week of 3/15/2010).  CMS was late with these approvals, so if you have begun your report on an older version, you simply need to do a Check for Updates (under Help in our software), and get the new version(s).  You must use these new version to file reports with FYE of 10/1/2009 and after.  See my earlier posts for the detailed changes in these Transmittals.

CMS recently pulished updated info about MAC Jurisdiction J-7 (AR, LA, MS).  CMS said “In taking corrective action CMS plans to issue a new solicitation to procure the A/B Medicare Administrative Contractor Jurisdiction 7 workload previously solicited under RFP-CMS-2007-0002.  CMS anticipates initiating the new procurement action in calendar year 2010.”  In essence, CMS is re-bidding J-7, so who knows when we will see a final award!

CMS issued Transmittal 17 for the SNF (2540-96), but has not yet issued approvals for the software.  I previously posted the details of the T.17 chnages.  T.17 is effective for FYE 10/1/2009 and after.  Once approved, this will be our Version 17.0.119.0, and available via a normal Check for Updates.

CMS issued Transmittal 8, which I previously posted on my Blog.  CMS has now issued Transmittal 9, which contains NO NEW Policy, but is to “clean up” T.8.  HFS is approved for T.8/9, but cannot release it until CMS finalizes T.9 (not expected prior to 3/12/2010).  T.8/9 must be used for FYE 10/1/2009 and after.  This will be our Version 9.0.119.0, and there will not be a “version 8″.  We use the current CMS Transmittal number for our Version number.  Once T.9 is finalized, it will be available via a normal Check for Updates.

CMS issued Transmittal 14, with changes I previously listed on my Blog.  CMS has now issued Transmittal 15, to “clean up” T.14 issues.  T.15 contains NO NEW Policy.  However, this does result in our never issuing a Version 14 (our Version Number always coincides with the current CMS Transmittal number).  We will issue Version 15.0.119.0 when CMS finalizes T.15 (not expected prior to 3/12/2010).  HFS is approved for T.15, but we cannot release it until CMS finalizes it, and advises us of same.  T.14/15 MUST be used for FYE 10/1/2009 and after.

CMS approved HFS for Transmittal 21 on 2/19/2010.  We had to make some subsequent CMS changes before we could release it.  This will be our version 21.0.119.0.  T.21 must be used for FYE 10/1/2009 and after.  This will be available via a normal Check for Updates, and should be posted to our web site by 3/8/2010.

CMS recently issued a new Transmittal 17 for the SNF, 2540-96. T.17 is effective for FY Begin 10/1/2009 and after (i.e. must use T.17, our version 17). W/S S-2 line 20 was revised to REQUIRE an answer, F for a Full report; L for a Low Medicare Utilization report; and N for a No Medicare Utilization report. W/S S-5, lines 10 and 11 are now N/A, effective for FYE 5/31/2009 and after, due to HIPPA data sensitivity. W/S S-4 part III, columns 5 and 6 (SCIC visits), is N/A effective for services on or after 1/1/2006. Similarly, W/S H-6, lines 8.05, 8.06, 8.09, and 8.10, are N/A for SCIC payments. W/S I-4 was revised for the H1N1 vaccine changes. Effective for services on or after 9/1/2009, new columns 2.01 and 2.02 were added for H1N1 Only, and Influenza and H1N1 combined, respectively. W/S E part III, line 10.04 is a NEW line added for Dual Eligible Bad debt Recoveries.
CMS issued a Draft Transmittal 8, for the RHC/FQHC (222-92 forms). This is effective for FYE on or after 10/1/2009 (i.e. must be used for these FYE). T.8 changes W/S B part I, line 1 instructions to emphasize that physician data (FTEs and Visits), for services furnished to facility patients by staff physicians working under a contractual agreement with an RHC on a regular ongoing basis in the RHC/FQHC facility, are placed on line 1, and are subject to productivity standards in accordance with 42 CFR 491.8. T.8 also modified W/S C part II, line 15 calculation to phase out the Outpatient Mental Health Treatment Limit of 62.5%, over 5 years. The Limit remains 62.5% for services through 12/31/2009. For services 1/1/2010 to 12/31/2011, the Limit is 68.75%. For services 1/1/2012 to 12/31/2012, the Limit is 75%. For services 1/1/2013 to 12/31/2013, the Limit is 81.25%. For services on or after 1/1/2014, the Limit is zero, or 100% reimbursement is computed. T.8 also modified W/S B-1 for the H1N1 vaccine costs. Effective for services on or after 9/1/2009, columns 2.01 and 2.02 were added to calculate the costs of H1N1. Medical Supply cost, Total Injections, and Medicare Injections must be identified (split), between Pneumococcal, Seasonal Influenza, H1N1 Only, and H1N1 and Influenza combined. Once T.8 Draft is finalized, we will have to process a CMS Test Case and get a new approval for our software.
CMS issued a new Transmittal 14 for the HHA (1728-94 Forms). It is effective for FYE on or after 10/1/2009 (i.e. must use T.14 for these FYE). T.14 implements the RHC/FQHC phase out of the Outpatient Mental Health Limit of 62.5%, over 5 years. W/S RF-3, line 14 calculation will remain 62.5% for services through 12/31/2009. For services 1/1/2010 to 12/31/2011, the Limit is 68.75%. For services 1/1/2012 to 12/31/2012, the Limit is 75%. For services 1/1/2013 to 12/31/2013, the Limit is 81.25%. For services on or after 1/1/2014, the Limit is zero, or 100% reimbursement is computed. T.14 also implements the H1N1 vaccine changes, effective for services on or after 9/1/2009. W/S RF-4 has added columns 2.01 and 2.02 to capture data and calculate the costs of H1N1 and Influenza vaccines. Medical Supply cost, Total Injections, and Medicare Injections must be split (identified) between Pneumococcal, Seasonal Influenza, H1N1 Only, and Influenza and H1N1 combined. T.14 codified the change to eliminate W/S S-3 part IV, columns 5 and 6, for SCIC. These columns are no longer used effective for services on or after 1/1/2008. T.14 also added the FI/MAC “name” to S-2 line 29.02, column 3. We have a table in our W/S S-2 HELP, with all the names. We are awaiting the CMS Test Case and beginning of the approval process for T.14.