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Detailed Information Required on New Medicare Cost Report

In April 2016, the Centers for Medicare and Medicaid Services (CMS) published the new Federally Qualified Health Center (FQHC) Cost Report, Form CMS-224-14.  This form replaced Form CMS 222-92 for FQHC entities, and is effective for cost reporting periods (which typically coincide with the year-end) beginning on or after October 1, 2014.

AAFCPAs would like to make clients aware that the new form has changed significantly and incorporates levels of detailed statistics not previously tracked by many FQHC entities.  Though the new Form does not calculate a rate for reimbursement, an average cost per discipline (medical and mental health) is calculated and compared to the current CMS GCode rate structure of the filing Health Center.  It is imperative that data be reported accurately in order to ensure costs of service are properly reflected and substantiate the current CMS GCode payment structure.  Additionally, CMS reports that the data collected will also be used to set future rates.

In order to complete the new Form, the filing Health Center must be prepared to gather a range of new detailed information.

A summary of changes to the Form and new required data is below:

Detailed Information Required on New Medicare Cost Report

AAFCPAs advises that you not delay, and begin now preparing for your cost report preparation and filing.  FQHCs will need to work with their billing departments to determine how to derive the detailed visit statistics needed, and consult with their finance team to determine how to derive the detailed cost data needed.

AAFCPAs is available for assistance in preparation and filing of the new FQHC Medicare cost report, and to provide guidance and best practices in implementing the changes.

If you have any questions, please contact your AAFCPA partner, or Matt Hutt, Partner, CPA, CGMA at 774.512.4043, mhutt@nullaafcpa.com.

About the Author

Matthew Hutt CPA
Matt leads AAFCPAs’ Healthcare Division, providing assurance, tax and advisory solutions for Federally Qualified Health Centers (FQHCs), behavioral health providers, home care agencies and hospices, nursing homes, and senior care living centers. Matt advises healthcare providers on consolidation and coordination of care, including the integration of behavioral health into the primary care delivery system. He also provides consulting solutions for providers transitioning to new value-based reimbursement models, and data driven patient care, including: developing business process and controls for collecting and advantaging data to provide analysis on: provider activity, delivery of care, and analysis of efficiency & cost effectiveness. Matt is also highly-sought after for his knowledge on issues related to affordable housing developers with requirements related to the US Department of Housing and Urban Development, MassHousing, Low Income Housing Tax Credits, Historical Tax Credits and New Markets Tax Credits. 

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