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Medicare Cost Report Electronic Signature Transmittals

CMS has revised the regulations at 42 CFR 413.24(f)(4)(iv) so that a provider submitting an Electronic Cost Report (ECR) for a cost reporting period ending on or after December 31, 2017, may elect to electronically submit the Medicare cost report Certification and Settlement Summary page (Worksheet S) with an electronic signature. CMS issued transmittals revising cost reporting forms for hospital (T-12/13), skilled nursing facility (SNF) (T-8), home health agency (HHA) (T-18), end stage renal disease (ESRD) facility (T-4), federally qualified health center (FQHC) (T-2), organ procurement organization (OPO) and histocompatibility laboratory (T-7), and hospice (T-3) providers to comply with the revised regulations.

Hospital Cost Reports:

A hospital with a cost reporting period ending on or after January 31, 2018, must submit a Medicare cost report using T-14. A hospital with a cost reporting period ending prior to January 31, 2018, may submit using T-13 or T-14. Both the T-13 and T-14 versions of the hospital ECR programs accommodate an electronic signature on the Medicare cost report Certification and Settlement Summary page for cost reporting periods ending on or after December 31, 2017.

SNF, HHA, ESRD, FQHC, OPO, Histocompatibility Laboratory, or Hospice Cost Reports:

The attached Schedule of Medicare Cost Report Transmittals and Effective Dates lists the cost report transmittals a SNF, HHA, ESRD, FQHC, OPO, histocompatibility laboratory, or hospice provider may use depending on the cost reporting period ending date, the date the provider creates the ECR, and if the provider elects to electronically sign the Medicare cost report Certification and Settlement Summary page. A SNF, HHA, ESRD, FQHC, OPO, histocompatibility laboratory, or hospice provider electing to electronically sign the Medicare cost report must submit using the most recent cost report transmittal that accommodates the electronic signature checkbox on the Certification and Settlement Summary page.

If a SNF, HHA, ESRD, FQHC, OPO, histocompatibility laboratory, or hospice provider creates the ECR prior to June 1, 2018, and does not elect to electronically sign the Medicare cost report Certification and Settlement Summary page, the provider may submit an ECR created using either the most recent cost report transmittal or the prior transmittal as listed on the Schedule of Medicare Cost Report Transmittals and Effective Dates. A SNF, HHA, ESRD, FQHC, OPO, histocompatibility laboratory, or hospice provider electing not to electronically sign the Medicare cost report Certification and Settlement Summary page must mail the Certification and Settlement Summary page with a wet signature in accordance with 42 CFR 413.24(f)(4)(iv).

Effective June 1, 2018, all SNF, HHA, ESRD, FQHC, OPO, histocompatibility laboratory, and hospice providers must create the ECR using the most recent cost report transmittal.

Rural Health Clinic (RHC) and Community Mental Health Clinic (CMHC) Cost Reports:
The electronic signature checkbox is not yet available on RHC or CMHC cost reports; therefore, the RHC and CMHC providers must continue filing in accordance with 42 CFR 413.24(f)(4)(iv) using Form CMS-222-92 T-13/14 or Form CMS-2088-92 T-8/9, respectively. CMS will issue a TDL with updated vendor approval listings upon issuance of the RHC and CMHC cost report transmittals that accommodate the electronic signature checkbox and incorporate the Form CMS-339.

Schedule of Medicare Cost Report Transmittals and Effective Dates

Cost Report Form

Transmittal #

Date Transmittal
Issued

Effective for Cost Reporting Periods Ending On/After

For cost reporting periods ending on or after 12/31/2017, cost report submitted with …*

Electronic Signature

Wet Signature*

CMS-2552-10
Hospital Cost Report*

T-12 / T-13

01/30/2018

09/30/2017

Transmittal approved as T-12/T-13.  For cost reporting period ending on or after 12/31/2017 and before 1/31/2018, hospital may submit using T-13 or T-14.

Transmittal approved as T-12/T-13.  For cost reporting period ending on or after 9/30/2017 and before 1/31/2018, hospital may submit using T-13 or T-14. *

T-14

03/16/2018

01/31/2018

Hospital must submit using the T-14.

For cost reporting period ending on or after 1/31/2018, hospital must submit using T-14.

CMS-2540-10 SNF Cost Report

T-8

03/09/2018

12/31/2017

SNF must submit using T-8.

Prior to June 1, 2018, SNF may create ECR using T-7 or T-8.  Effective June 1, 2018, SNF must create the ECR using T-8.

CMS-1728-94  HHA Cost Report

T-18

03/16/2018

12/31/2017

HHA must submit using T-18.

Prior to June 1, 2018, HHA may create ECR using T-17 or T-18.  Effective June 1, 2018, HHA must create the ECR using T-18.

CMS-265-11 ESRD Cost Report

T-4

02/16/2018

12/31/2017

ESRD must submit using T-4.

Prior to June 1, 2018, ESRD may create ECR using T-3 or T-4.  Effective June 1, 2018, ESRD must create the ECR using T-4.

CMS-224-14 FQHC Cost Report

T-2

03/09/2018

12/31/2017

FQHC must submit using T-2.

Prior to June 1, 2018, FQHC may create ECR using T-1 or T-2.  Effective June 1, 2018, FQHC must create the ECR using T-2.

CMS-1984-14 Hospice Cost Report

T-3

04/13/2018

12/31/2017

Hospice must submit using T-3.

Prior to June 1, 2018, hospice may create ECR using T-2 or T-3.  Effective June 1, 2018, hospice must create the ECR using T-3.

* The Form CMS-2552-10, T-12/T-13, includes instructions for cost reporting periods ending on or after 9/30/2017 in the Wet Signature column.

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