VII. Common Assessable and non-Assessable Questions


Question 1: Are Medicaid receipts assessable?

Question 2: Are Medicare receipts assessable?

Question 3: For RHCFs, are adult day services/adult day care revenues assessable?

Question 4: Are non-operating revenues subject to the assessment?

Question 5: Are rate add-ons (i.e. Worker Recruitment, Training and Retention rate add-ons and Accessibility, Quality and Efficiency rate add-ons) treated the same as the grants listed as non-assessable income?

Question 6: Are Nursing Home Financially Disadvantaged Payments (rate code 38) assessable?

Question 7: For LTHHCPs, are cash receipts from Meals on Wheels and other Home Delivered Meals assessable?

Question 8: Is revenue received by one provider type from another provider type where both are required to pay the assessment, considered net revenue for purposes of making assessment payments to the Department's pool administrator?

Question 9: Should I report services rendered for paraprofessional contracts?

Question 10: Are payments collected for COBRA, insurance or retirement plans on behalf of employees assessable?



Question 1: Are Medicaid receipts assessable?

Answer 1: All Medicaid receipts, including Medicaid managed care and PACE are assessable.

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Question 2: Are Medicare receipts assessable?

Answer 2: Medicare receipts are assessable for Hospitals, CHHAs, LTHHCPs and Personal Care Providers.

For the RHCFs, effective on or after October 1, 2002, receipts attributable to payments made pursuant to Title XVIII of the federal Social Security Act (Medicare), including a Medicare Managed Care Benefit Plan, are exempted from this assessment as authorized by PHL Section 2807-d(2)(b)(vi). This exemption will extend to payments received to satisfy Medicare coinsurance and/or deductible requirements for otherwise covered benefits. The assessment, however, will apply to receipts from payments made for a service, which is not covered by Medicare including benefits, which are exhausted due to Title XVIII coverage limits. To accommodate this exemption, the Medicare receipts will be reported on Schedule A of the Health Care Facility Cash Receipts Assessment Report.

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Question 4: For RHCFs, are adult day services/adult day care revenues assessable?

Answer 4: Yes, adult day services/adult day care revenues are assessable.

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Question 5: Are non-operating revenues subject to the assessment?

Answer 5: Non-operating revenue is not subject to the assessment to the extent that the revenue meets the definition under generally accepted accounting principles and is appropriately shown on the cost report. A list of assessable and non-assessable revenue is included in the reporting instructions on this website.

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Question 7: Are rate add-ons (i.e. Worker Recruitment, Training and Retention rate add-ons and Accessibility, Quality and Efficiency rate add-ons) treated the same as the grants listed as non-assessable income?

Answer 7: No, adjustments paid through Medicaid rate add-ons are considered Medicaid operating revenue, and are therefore assessable revenues. Grants paid directly to a provider are non-assessable revenues.

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Question 8: Are Nursing Home Financially Disadvantaged Payments (rate code 38) assessable?

Answer 8: Yes, they are assessable.

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Question 9: For LTHHCPs, are cash receipts from Meals on Wheels and other Home Delivered Meals assessable?

Answer 9: No, these are considered waivered services and therefore non-assessable.

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Question 10: Is revenue received by one provider type from another provider type where both are required to pay the assessment, considered net revenue for purposes of making assessment payments to the Department's pool administrator?

Answer 10: . Revenue received by one designated provider of service from another designated provider of service for subcontracted services would not be assessable revenue.

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Question 11: Should I report services rendered for paraprofessional contracts?

Answer11: If you are billing Medicaid, Medicare (non-RHCF providers), commercial and not-for-profit third-party insurers or patients for these services, you should pay the assessment on these services.

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Question 12: Are payments collected for COBRA, insurance or retirement plans on behalf of employees assessable?

Answer 12: No, these types of payments are not considered revenue.

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