2020 Institutional Cost Report (ICR)
NYS Department of Health
Division of Finance & Rate Setting
Bureau of Hospital & Clinic Rate Setting
- 2020 Presentation is also available in Portable Document Format (PDF)
June 10, 2021
Agenda
- ➣ Software, Support & Filing Procedures
- ➣ ICR Audit Fees
- ➣ Health Commerce System
- ➣ Department of Health Public Website
- ➣ 2020 ICR Updates
- ➣ Future Updates
- ➣ Questions
Software, Support & Filing Procedures
- ➣ Obtaining Software and Support
- Software will be available for download from the Health Financial Systems (HFS) website.
Note: The Department will provide hospitals with the URL, Username and Password using the Health Commerce System (HCS).
- Software will be available for download from the Health Financial Systems (HFS) website.
- ICR problem resolution and questions:
- Hospital.ICR@health.ny.gov
Note: please do not send via secure email – DOH security prohibits these emails - For problem resolution, send your "four-pack" files (CR, IC, B_, T_) to this address. The files will then be forwarded to KPMG, if necessary.
- Hospital.ICR@health.ny.gov
- ➣ Electronic Filing Procedures
- DH file (HCS electronic submission):
- Due date: Monday, August 2, 2021
- Electronic submission of documents within 5 Business days of electronic DH file submission:
- Signed CFO/CEO certification
- Edit Report (Initialed with explanations)
- Final Audited Financial Statements
- ✓ "Draft" statements cannot be used for audit purposes
- Email files to: AFS@health.ny.gov
Note: please do not send via secure email – DOH security prohibits these emails - Signed CFO/CEO Certification:
- File named with 7-digit operating certificate number and "_CFO"
- Example: 1234567_CFO
- File named with 7-digit operating certificate number and "_CFO"
- Edit Report (initialed with explanations):
- File named with 7-digit operating certificate number and "_Edits"
- Example: 1234567_Edits
- File named with 7-digit operating certificate number and "_Edits"
- Audited Financial Statements:
- File named with 7-digit operating certificate number and "_AFS"
- Example: 1234567_AFS
- File named with 7-digit operating certificate number and "_AFS"
- DH file (HCS electronic submission):
2020 ICR Audit Fees
- ➣ Due at time of filing
- ➣ Same fee schedule as previous years
- ➣ Same payment process as previous years
- ➣ Email notification to be released for facility-specific fees
- ➣ Fee schedule
Health Commerce System (HCS)
- ➣ Website
- ➣ Communication Tool
- Secure network for posting provider information
- Keep email address current
- ✤ Facility´s responsibility
- ✤ Email blast separate from public website electronic mailing list
- ➣ HCS Help Contact
- Commerce Accounts Management Unit (CAMU) Help Desk: 1-866-529-1890 or camu@its.ny.gov
- ✤ HCS accounts
- ✤ Password resets
- ✤ Removal of employee
- Commerce Accounts Management Unit (CAMU) Help Desk: 1-866-529-1890 or camu@its.ny.gov
- ➣ HCS Access Contact
- Hospital Fee-for-Service Rate Unit: HospFFSunit@health.ny.gov
- ✤ Receiving access to the ICR (or other hospital applications)
- ✤ Rate related questions
- Hospital Fee-for-Service Rate Unit: HospFFSunit@health.ny.gov
Department of Health Public Website
- ➣ Information posted for ICR
- ➣ Information posted for Inpatient Rates and Weights
- ➣ Information posted for APG Rates and Weights
- ➣ Electronic Mailing List Subscriptions
2020 ICR Updates
- ➣ Psychiatric Services
- Inpatient Dual-Diagnosis Psychiatric (NEW for 2020)
- Cost Center 378 (Medicare line 40.01)
- Exhibit 32/52 – Medicaid Service Code (MSC) 204
- Exhibit 46 – report revenue for new service
- Comprehensive Psychiatric Emergency Program (CPEP) Observation
- Effective 4/1/2020 – OMH Fee-for-Service outpatient rate code 4049
- 2020 ICR – accommodates based on effective billing periods
- Exhibit 32 – MSC 202 prior to 4/1/2020
- Exhibit 33/52 – MSC 293 effective 4/1/2020
- Exhibit 46 – NEW Line 015, routine charges
- ➣ Clinic Services
- Federally Qualified Health Center / Rural Health Center
- Exhibit 1 – "Are any hospital FQHC / RHC sites paid by APGs? Y/N"
- FQHC rate – all inclusive federal rate
- APG rate – physicians are carved out (billed separately)
- FQHC / RHC cost centers are excluded from Medicaid only automated ICR physician´s adjustment (Line 633)
- FQHC´s / RHC´s that opt into APG´s may require Medicaid only physician´s adjustment on Exhibit 14 if carve out was not automatically done
- Exhibit 1 – "Are any hospital FQHC / RHC sites paid by APGs? Y/N"
- Chemical Dependency Clinic/Rehab
- Cost Center 291 – Header updated
- Exhibit 33 – only hospital-based visits should be reported
- Use Medicaid Service Code (MSC) 248 "Other OASAS Programs"
- ICR Schedules – distinctly reported (no longer reported under MSC 235 General Clinic)
- Federally Qualified Health Center / Rural Health Center
- ➣ Out-of-State Sites
- Services provided outside New York State
- Out-of-State sites are not certified or monitored by New York State
- Exhibit 1 – "Does this hospital provide services at any site outside New York State?" Y/N
- List of services – check box
- "Other" provide short description
- Distinct cost center
- Medicaid Service Code 959 for associated costs or adjust on Exhibit 14 – MA only
- No utilization should be reported on Exhibits 32, 33 or 34
- Out-of-state payments are based on upstate and downstate average rates from NYS hospitals
- Services provided outside New York State
- ➣ Exhibits
- Exhibit 14 - Adjustments
- Article 31 Hospitals – excluded from automated Medicaid only physician´s adjustment
- No longer requires manual add-back of physician´s expenses
- Article 31 Hospitals – excluded from automated Medicaid only physician´s adjustment
- Exhibit 30 – Inpatient & Swing Bed Statistics
- Non-fatal edit when dual-eligible days/discharges are left blank or have 0´s
- Combined Medicaid Primary & Dual-eligible (excludes service areas not part of inpatient hospital definition, such as Transitional Care Units)
- Exhibit 31A – Transfer Statistics
- Prior Year - Charge-based statistic
- Will not allow change to visits (1) if charges (0) are already being used
- Service column closed to data entry
- Prior Year - Charge-based statistic
- Exhibit 32 – Inpatient Days & Discharges
- New – Dual-Diagnosis Psychiatric
- Will display as "N/A" for hospitals not certified
- Exhibit 33 – Outpatient Visits
- CPEP Observation Beds (NEW)
- Report days versus visits (rate code 4049)
- MSC 293
- Chemical Dependency Clinic/Rehab
- See slide 11 for MSC change
- Header changes
- PROS to PROS Monthly (Personalized Recovery Oriented Services)
- CPEP to CPEP Emergency
- Alcohol/Chemical Dependency Clinic to Chemical Dependency Clinic/Rehab
- CPEP Observation Beds (NEW)
- Exhibit 40 – Detail of Capital Expenses
- Modified non-projectable capital
- Line 004, Real Estate Taxes – Buildings and Fixtures
- Line 088, Real Estate Taxes – Movable Equipment*
- Line 005, Property Insurance – Buildings and Fixtures
- Line 089, Property Insurance – Movable Equipment
- Modified non-projectable capital
- Exhibit 40 – Detail of Capital Expenses
DETAILS RE: CAPITAL RELATED COST BUILDINGS & FIXTURES LINE # RECLASSIFIED BUILDINGS & FIXTURES RECLASSIFIED MOVABLE EQUIPMENT RECLASSIFIED TRIAL BALANCE ALL PAYOR AND MEDICAID ADJUSTMENTS DIRECT CHARGE CAPITAL TOTAL CAPITAL RELATED COSTS 1 2 3 4 5 6 7 8 21045 21046 0140 0335 0404 0405 0401 0402 DEPRECIATION - NON 28B 001 AMORTIZATION OF LEASEHOLD IMPROVEMENTS 002 PROPERTY RENTAL 003 REAL ESTATE TAXES - BUILDINGS AND FIXTURES 004 REAL ESTATE TAXES - MOVEABLE EQUIPMENT 088 PROPERTY INSURANCE - BUILDINGS AND FIXTURES 005 PROPERTY INSURANCE - MOVEABLE EQUIPMENT 089 INTEREST EXPENSE - CAPITAL DEBT - NON 28B 006 OPERATING LEASES 007 CAPITALIZED LEASES 008 - Real Estate Taxes & Property Insurance
- Each line designated as Buildings and Fixtures or Movable Equipment
- Non-related column - closed to data entry
- Other than Real Estate Taxes or Property Insurance
- Continue to report expenses under appropriate column
- Purpose of Change
- Discrete reporting of All-Payor / Medicaid only Adjustments
- Discrete reporting of Direct Charge Capital
- Exhibit 14 - Adjustments
- Exhibit 46 – Hospital Service Revenue
- NEW Line 015, routine charges
- Used for transfer cost calculation associated with CPEP Observation
- NEW Line 015, routine charges
- ➣ ICR Schedules
- ICR Schedule 1B – Transfers by Service
- Based On Visits
- Will not display when Exhibit 31A Transfer Basis = Charges
- CPEP–Observation Beds (NEW)
- Transfers based on charges – Exhibit 46, line 015
- Based On Visits
- ICR Schedule 2A – Uncompensated Care Utilization & Collections (NEW)
- New for 2020
- Used in the Indigent Care Pool calculation
- Data is driven by proper MSC coding on Exhibits 32 & 33
- ICR Schedule 3 Part 1 – Allowable Capital Costs
- Non-Projectable Capital - Property Tax & Insurance
- From Exhibit 40 – Total Capital Related Costs (Col 0402)
- Non-Projectable Capital - Property Tax & Insurance
- ICR Schedule 3 Part 2 – Distribution of Allowable Capital
- Carried forward Total Reported (63200/960) from Part 1
- Rounding Differential = Total Reported Part 1 less the sum of all distributed capital from Part 2
- ICR Schedules – All
- New/Revised Medicaid Service Codes (MSCs)
- 204 – Dual-Diagnosis Psychiatric
- 293 – CPEP Observation Beds
- 248 – Other OASAS (Chemical Dependency Clinic/Rehab)
- New/Revised Medicaid Service Codes (MSCs)
- ICR Schedule 1B – Transfers by Service
- ➣ Edits & Instructions
- Edits
- Several non-fatal edits have been added or modified
- List of edits will be available on the NYS ICR web page
- Instructions
- Instructions have been added or updated based on:
- Changes / Additions implemented in 2020
- Q&As incorporated from 2019
- Additional Clarifications
- Instructions have been added or updated based on:
- Edits
Future Updates
- ➣ COVID Reporting – 2020 ICR
- ICR and/or Instruction updates expected based on guidance from the Centers for Medicare and Medicaid (CMS)
- ➣ CPEP Observation – 2021 ICR
- Removal from Exhibit 32 (Exhibit 33 reporting only)
- ➣ Essential Plan Reporting – 2022 ICR
- Two new payer categories to be added to various exhibits & ICR Schedule 2
- "Essential Plans 1 & 2" and "Essential Plans 3 & 4"
Questions?
ICR Questions: Hospital.ICR@health.ny.gov
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