Last Modified: 3/10/2021
Location: FL, PR, USVI
Business: Part A
After you have filed an initial cost report, if you find there is a material error that substantially affects reimbursement, you may find it appropriate to file a request for an amended cost report. CMS Medicare Publication 15-1, Chapter 29, section 2931.2
allows the MAC to accept an amended cost report under limited circumstances, specifically:
1. Correct material errors detected subsequent to filing the original cost report,
2. Comply with health insurance policies or regulations, or
3. Reflect the settlement of a contested liability.
An amended cost report is one which is intended to revise information submitted on a cost report which had been previously filed by the provider. An amended cost report cannot be filed to avail yourself of a cost reporting election that could have been made prior to submitting your report. For example, you may not amend a cost report to modify the allocation methodology used for step-down on worksheet B-1. The amended cost report should be filed prior to the audit staff reviewing the original submitted cost report. Where you are not sure if it is appropriate to file an amended report or simply request a change be made during the audit review, you should discuss this with your audit manager.
To file an amended cost report, please do the following:
• Submit a cover letter to First Coast, with the cost report fiscal year end that indicates what items were originally submitted on the as-filed cost report, what you are changing, and the reason for the change.
• With each issue, provide as much supporting documentation as necessary to justify each change as well as the Medicare reimbursement effect for each issue.
• If you are amending a hospital, skilled nursing facility, home health agency, end-stage renal disease, community mental health center, federally qualified health center, or rural health cost report, you must submit a new disk with the electronic cost report changes incorporated along with a signed and encrypted signature page. We recommend using a color other than black for your original signature to avoid any confusion regarding original signatures versus photocopies.
Once the amended cost report is received in our office, we will review it for acceptability and determine if it is a valid and acceptable amended report. If we deny a portion of your request, you can decide to refile for the issues not in dispute.
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