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October 3, 2024

CR 13413 Questions & Answers

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Where can I find a copy of CR 13413?
- CR 13413 is posted on the CMS website.
  
  Note: CMS may rescind and replace a transmittal. To ensure you access the most recent transmittal, go to CMS Transmittals, and filter on the CR number.
Where can I find the Supplemental Security Income (SSI) realignment ratios?
- CMS posted SSI fractions pursuant to CMS-1739-F.
Under CR 13413, which cost reports can request an SSI realignment?
- Any cost reports with cost report beginning dates starting before October 1, 2013, can request an SSI realignment.
When is the effective date for CR 13413?
- The effective date for CR 13413 is July 31, 2024.
For cost reporting periods beginning before October 1, 2013, if I made an SSI realignment request prior to the publication of CR 13413, do I need to send an SSI realignment request again?
- Yes. Per business requirement 13413.2.2, Medicare Administrative Contractors (MACs) shall only process new or confirmed realignment requests for cost reporting periods starting before October 1, 2013, that are received after the CR effective date (July 31, 2024).
Does the SSI realignment request follow the 3-year reopening timeline?
- SSI realignment is not subject to the 3-year reopening time limit. In other words, a hospital can request an SSI realignment at any time.
Is it correct that the 24 months processing time (business requirement 13413.3.3) only applies to the MAC? Can providers still request realignment many years from now, for any or all years before October 1, 2013?
- That is correct. Hospitals can request SSI realignment at any time.
Is the SSI realignment subject to the reopening materiality parameter established by the MAC?
- No. Providers have a statutory right to request and receive realignment regardless of reimbursement impact. MACs must process all requests for realignment regardless of the impact.
What am I required to include in the SSI realignment request?
- Each provider’s SSI realignment request must contain:
  - Cost report begin date,
  - Cost report end date
Where can I send my SSI realignment requests or questions?
- Please send SSI realignment requests and questions to: J15.CR.REOPENING@cgsadmin.com.
  
  For SSI realignment requests for cost reports before October 1, 2013, please include “CR13413 and Provider Number” in the subject line.
  
  If you have requests for multiple providers and cost reporting periods, please send a separate email for each provider number. Each provider can request multiple years in the same email. Please ensure you include the required information for each cost reporting period that you want to realign:
  - Cost report begin date,
  - Cost report end date
Should the SSI realignment request include information beyond the provider number and cost report begin and end date?
- For SSI realignment requests under CR 13413, we recommend you submit the documents listed below.
  
  Please note: You aren’t required to provide the documentation below. CGS will process the realignment request without it. However, this documentation will help us expedite your realignment request.
  - Latest settled cost report (PDF version)
  - Latest settled cost report electronic file, if available
  - Latest Notice of Amount of Medicare Program Reimbursement letter (NPR)
  - Original DSH Workpaper supporting the DPP payment included in the latest settled cost report
  - The reimbursement impact of your SSI realignment request
Once a provider requests a realignment under CR 13413, can we withdraw the request?
- In accordance with existing rules regarding realignment requests (42 CFR 412.106(b)(3)), once a hospital confirms its request for realignment of cost reporting periods starting before October 1, 2013, or makes a new request for such a reporting period, you may not withdraw the request. The realigned ratio for the cost reporting period posted on the CMS DSH website will be the hospital’s ratio, regardless of whether the ratio is higher or lower than the Federal Fiscal Year ratio.
Under CR 13413, are providers only required to confirm begin/end dates for “SSI realignments” unrelated to 1498-R, or are they also mandatorily required to confirm years under a 1498-R remand that still need to be settled to the FFY SSI% with the “total” amount?
- CR 13413 only requires providers to confirm the cost report begin and end date for SSI realignment requests and not for 1498-R remands. If you send an SSI realignment request, be sure to include the cost report begin and end dates in your request.

If a provider is awaiting a 1498-R remand to be settled to the FFY SSI ratio of the “total” amount, and would also like to request an SSI realignment based on the hospital’s fiscal year, is it possible to request for this to occur simultaneously? In the table below, shown merely as an example, would the provider’s SSI% update from 6.35% to 6.50%? Or will you first settle with the 1498-R FFY SSI% of 6.25%, causing a loss for the provider, and then process the SSI realignment to 6.50%?

Current FFY SSI Ratio	1498-R Total FFY SSI Ratio	Cost Report Year SSI Ratio
6.35%	6.25%	6.50%

You can request your SSI realignment any time.

For those providers that are still waiting for a 1498-R remand, we will issue a revised NPR for the 1498-R remand first. If an SSI realignment request was received after July 31, 2024, for the same provider/year, it will process after the 1498-R revised NPR. For the example above, we will first settle with the 1498-R FFY SSI% of 6.25%. The SSI realignment will then process to 6.50%. We won’t be able to process both 1498-R and CR 13413 SSI realignment requests simultaneously.

When can I expect my CR 13413 SSI realignment to process?
- We will issue a revised NPR within 24 months of the provider’s new or confirmed CR 13413 SSI realignment request. If we’re required to forward an SSI realignment request to CMS for the situations described in business requirement 13413.2.5, the date of CMS direction becomes the verified realignment request date, and we will issue a revised NPR within 24 months of that date.

License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

AMA Disclaimer of Warranties and Liabilities.

CMS Disclaimer

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

CR 13413 Questions & Answers

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