Medicare Advantage Beneficiary Information Submission Requirement for Hospitals
CMS is requiring non-teaching hospitals to submit informational only bills for Medicare Advantage (MA) beneficiaries they treated in FY 2007 and FY 2008 on or before August 31, 2010 and submit a related attestation or before September 15, 2010. This requirement is a follow-up to a 2007 transmittal requiring all hospitals paid under the inpatient prospective payment system (PPS), inpatient rehabilitation facility PPS, and long term care hospital PPS to submit such data in order to determine the Supplemental Security Income ratio and accurately determine a variety of Medicare payment amounts. CMS has determined that many hospitals have not reported any MA days. CMS therefore is giving applicable hospitals one final opportunity to comply with the requirement to submit FY 2007 and 2008 informational only claims. In addition, these hospitals must attest in writing to their Medicare contractor that they have either submitted all of their MA claims for FY 2007 and 2008 or that they have no MA claims for that fiscal year. If a provider does not comply, CMS may instruct the contractor to use an SSI ratio of 0% to calculate Medicare disproportionate share hospital payments or take other action that may affect payments for the non-compliant providers.
