NEWS YOU CAN USE: Keep Final Cost Report Details in Check

Pool refunds don't equal "charitable donations"

Don't fudge taxes and expenses on final cost reports

The HHS Office of Inspector General (OIG) May 20 gave the final word on how provider tax refunds and expenses should -- and shouldn't -- be handled on your cost reports. Fifteen hospitals that received pool refunds from the Missouri Hospital Association will end up having to pay money back to the feds, according to a May 20 OIG audit report titled "Review of the Classification of Missouri Pro-vider Tax Refunds on Hospitals'Medicare Cost Reports" (A-07-02-04006).
The OIG says the pool refunds, which allowed some of the provider tax refund to be redistributed among hospitals negatively affected by the tax, were reported incorrectly as Medicaid revenue instead of as a reduction of the tax expense. Total cost report errors found during the audit, including an unallowable scholarship fund and a poison control center claimed by four hospitals, rang up $8.4 million in Medicare overpayments, according to the audit.
So why not claim the pool refunds as "charitable donations"? After all, hospital officials pointed out, that's what several large accounting firms did in the mid 1990s. The OIG: Don't buy it. Even though the pool refund transactions are voluntary, the transfers are still conditional on a formal agreement set up by the association and fall short of official standards for charitable contributions. To read the report, go to http://oig.hhs.gov/oas/reports/region7/70204006.pdf.

Make your voice heard in the EMTALA advisory group

You could have a hand in shaping hospitals'responsibilities under the Emergency Medical Treatment and Labor Act (EMTALA) because CMS is looking for your viewpoints. The agency is now taking your nominations for a technical advisory group that could change how physicians and hospitals manage emergency department (ED) patients.
CMS claims the advisory group, which the reform bill mandates, will go a long way toward striking a regulatory balance between patients, hospitals and physicians. "Last year, the department took an important first step by clarifying and simplifying our EMTALAreg-ulations to protect patient rights and give clear guidance to providers. I have every expectation that this advisory group will have additional ideas for us to further improve the regulations," said CMS Administrator Mark McClellan.
According to the May 28 Federal Register, the following representatives will make up the advisory group:


four hospital representatives, at least one of which must be public

seven practicing physicians from emergency medicine, cardiology or cardiothoracic surgery, orthopedic surgery, neurosurgery, pediatrics or a pediatric subspecialty, obstetrics-gynecology, and psychiatry

two patient representatives

two CMS regional office [...]

- Published on 2004-06-10