Summary of Changes_2012 Cost Reports vj508

The Division of Capitated Plan Audits is responsible for updating the cost reports and
cost report instructions (Form CMS 276) for the cost-based Managed Care Organizations
reimbursed on the reasonable cost basis. DCPA is requesting approval of a revised
version of the currently approved Form CMS 276. The revised package has to be turned
to OSORA by 10/17/2012 to be published in the Federal Register for comments.
The main purpose of the revisions was to implement some changes in response to the
Affordable Care Act, which eliminated Part B coinsurance and deductibles for the
majority of preventative services. Additional updates were made to eliminate redundant
information and make improvements to the cost reports. Please note that this updated
version can not reflect any of the anticipated/future policy changes until they have been
finalized and implemented.
Summary of Changes
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Added lines to various worksheets to report Part B cost not subject to deductible
and coinsurance (result of ACA)

•

Moved other lines and modified formulas as a result of changes above

•

Added a line for reporting of non-allowable costs to be able to allocate
administrative expenses to non-allowable cost centers

•

Added formulas for summing statistics for different supplier types and
transferring those figures to another worksheet

•

Added auto-fill formulas to avoid user errors

•

Removed Worksheet B, Part I from the Budget Forecast as this information is
reported on Worksheet N of the Final Cost Report.

•

Added formula to display an error message to alert cost plans when the proposed
premium is greater that the amount allowed to be collected.

Level of Effort
While plans are required to report Part B services not subject to coinsurance and
deductible separately, CMS believes that this information has to be tracked and available
to plans to make proper payments. In addition, CMS removed certain reporting
requirements and automated the flow of certain figures. Therefore, the proposed changes
will not change the level of effort needed to complete the forms.