HOSPITAL PAYMENT CALCULATION INSTRUCTIONS Key Points: Discharges and inpatient bed-days are limited to those from the acute care portion of a hospital. The Federal rule excludes the following from being considered in the payment calculations. The following should be excluded from the Medicare Cost Report information: Nursery bed days and nursery discharges for newborns discharges. Swing bed days that are used to furnish skilled nursing facility or nursing facility level of care. Services rendered in the psychiatric unit of the hospital which is a distinct part of the hospital Services rendered in the rehabilitation unit of the hospital which is a distinct part of the hospital Medicaid acute inpatient-bed-days may not include those patients for which Medicare paid a share (dually eligible recipients). Charity care should not include bad debt charges. Calculator Instructions: the base hospital fiscal year: Base Year: The base year is most recent 12 month period that data is available When the base year is entered, the previous 3 years will automatically populate on the calculator. Enter the appropriate information for the specified fiscal year cost report as identified on the form. Depending on whether you are using the 2552-10 or the 2552-96 Medicare Cost Report form, you will pull the specific information from the cost reports. When the data has been entered, select the Calculation Tab. Scroll to the bottom to see the esimtated payment amounts which are calculated over three years. Payments: Medicaid will calculate payments for all eligible hospitals information submitted on the hospital’s enrollment document. The amount of the calculation will be presented to the hospital for review prior to final eligibility determination. It is a requirement that auditable data sources be used to calculate EHR hospital incentive amounts. The most recent Medicare cost reports will be used to validate the information. Payments to eligible hospitals will be made over a three-year time period: 50 percent in the first year, 40 percent in the second year 10 percent in the third year.
HOSPITAL PAYMENT CALCULATION INSTRUCTIONS Key Points: Discharges and inpatient bed-days are limited to those from the acute care portion of a hospital. The Federal rule excludes the following from being considered in the payment calculations. The following should be excluded from the Medicare Cost Report information: Nursery bed days and nursery discharges for newborns discharges. Swing bed days that are used to furnish skilled nursing facility or nursing facility level of care. Services rendered in the psychiatric unit of the hospital which is a distinct part of the hospital Services rendered in the rehabilitation unit of the hospital which is a distinct part of the hospital Medicaid acute inpatient-bed-days may not include those patients for which Medicare paid a share (dually eligible recipients). Charity care should not include bad debt charges. Calculator Instructions: the base hospital fiscal year: Base Year: The base year is most recent 12 month period that data is available When the base year is entered, the previous 3 years will automatically populate on the calculator. Enter the appropriate information for the specified fiscal year cost report as identified on the form. Depending on whether you are using the 2552-10 or the 2552-96 Medicare Cost Report form, you will pull the specific information from the cost reports. When the data has been entered, select the Calculation Tab. Scroll to the bottom to see the esimtated payment amounts which are calculated over three years. Payments: Medicaid will calculate payments for all eligible hospitals information submitted on the hospital’s enrollment document. The amount of the calculation will be presented to the hospital for review prior to final eligibility determination. It is a requirement that auditable data sources be used to calculate EHR hospital incentive amounts. The most recent Medicare cost reports will be used to validate the information. Payments to eligible hospitals will be made over a three-year time period: 50 percent in the first year, 40 percent in the second year 10 percent in the third year.
EH_PaymentCalculationInstructions.docx