A. The Contractor must receive the Department-prepared hospital data (Data), which will be delivered in electronic format. Data will include the completed PBC forms and supporting documentation. B. The Contractor must review Data for reasonableness and completeness, input Data into the Cost Report software program, then prepare and submit the Cost Report in the standardized electronic cost reporting (ECR) format. C. The Contractor must prepare and complete both the annual Medicare Cost Reports and the annual Medicaid Cost Reports (hereafter both referred to as Cost Reports) for each fiscal year ending (FYE) June 30, throughout the term of the contract. Cost Reports must include, but not be limited to, related schedules, required copies, and documentation as follows: 1. One (1) copy of the Medicare Cost Report, form CMS 339, complete work papers, required electronic media for the Departments files, required number of Cost Report copies, and work papers to be submitted to the Department's intermediary where required. 2. Written instructions regarding which forms require signature, number of copies to submit, where to mail the information and due date. 3. Transmittal Letter (T-letter) identifying areas of potential concern or opportunity. 4. The Contractor's recommendations for further action or follow-up. D. The Contractor must deliver the completed reports, respective schedules and copies, to the Department no later than the 1st week of November of each contract year. E. The Contractor must organize the Cost Reports by each adult program, the adolescent program and the nursing facility according to Centers for Medicare and Medicaid Services (CMS) requirements. F. The Contractor must use approved CMS software to prepare the Cost Reports. G. The Contractor must ensure that the Cost Reports meet the applicable requirements of Medicare, Medicaid, State and Federal; and include an electronic copy. H. The Contractor must prepare the Cost Reports and submit to the Department for fee determination no later than November 7th of each contract year. I. The Contractor must organize the report for fee determination by all of SHS, SHN, and SHW programs and include all costs related to SHS, SHN, SHW operation. J. The Contractor must conduct a one (1)-time, two (2)-day, webinar training on the Cost Reports process. This training must include the following areas: 1. A "walk through" of the current Cost Reports process so that Department staff will gain a better understanding of the information required by the process. 2. A review of bad debt processes and reporting; and instructions given to adhere to the new WS-10 reporting requirements. 3. A review of services currently being provided by the Department; which must include billing practices for Medicare Part B outpatient clinic, and a review of billing for the three (3) populations at SHS, SHN, and SHW; Adult, Adolescent, and Geriatric; adding instructions for improvement. 4. A review of pharmacy billing practices for Medicare Part D, adding instructions on improving the process for billing of drugs charged to patients for the three (3) populations at SHS, SHN, and SHW. 5. The Department will provide the Contractor with the following information for training purposes: a. Current year-to-date general ledger. b. Current year-to-date revenue and usage report showing usage for each item charged. K. The Contractor must provide ongoing consultation to hospital staff by telephone and email regarding such topics as ancillary billing, billing practices, audits of cost reports, reimbursements, and recoupments. This consultation must be in addition to, and not included in, the cost report preparation and on-site training tasks identified above.
