Last Modified: 6/22/2020
Location: FL, PR, USVI
Business: Part A
Q: What happens if I do not file my cost report timely?
A: The penalty for not filing the cost report timely is that 100 percent of any payments will be withheld. In addition, providers will be assessed interest at the prevailing rate at the time the cost report is due. Furthermore, if the cost report cannot be submitted by the due date, providers may request a reduced payment suspension rate of 50 percent during a grace period of 60 days. This request should be submitted before the due date of the cost report. On the 61st day, if the cost report has not been filed, the rate of suspension will change to 100 percent. If a provider fails to request a reduction in the suspension rate or if the Medicare Administrative Contractor (MAC) does not concur with the request for a reduced suspension rate, then 100 percent of the provider’s payments will be suspended if the cost report is not filed timely. Terminated providers will immediately have 100 percent of their payments suspended for failure to file a cost report. According to Provider Reimbursement Manual 15-2 Section 104, “No extension will be granted except when provider’s operations are significantly adversely affected due to extraordinary circumstances over which the provider has no control. An example would be a flood or fire that forces a provider to cease operations and to transfer its patients temporarily to other providers outside of the impacted area.”
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