a) Excepting
those operated by an agency of the United States government, all hospitals in
Illinois and hospitals in contiguous states providing 100 or more paid acute
inpatient days of care to the Illinois Medicaid Program shall be required to
file Medicaid and Medicare cost reports within 150 days after the close of that
provider's fiscal year. Any hospital accredited by TJC or another Health and
Human Services Approved Accreditation Organization not eligible for or subject
to Medicare certification shall be required to file financial statements, a
statement of revenues and expenses by program and census logs by program and
financial class. The Bureau of Health Finance may request an audit of the
financial statements by an independent Certified Public Accountant (CPA) firm
if the financial statements are to be used as the base year for rate
analysis.
b) No extension of the
Medicaid cost report due date will be granted by the Department unless the
Centers for Medicare and Medicaid Services (CMMS) grants an extension of the
due date for the related Medicare cost report. Should CMMS extend the Medicare
cost report due date, the Department will extend the Medicaid and Medicare cost
reports due date by an equivalent period of time.
c) If the hospital has not filed the required
Medicaid cost reports within 150 days after the close of the hospital's fiscal
year, the Department shall suspend payment for covered medical services until
the Department receives the required information.
e) Cost Report Reviews
The Bureau of Health Finance shall audit the information
shown on the cost reports. The audit shall be made in accordance with generally
accepted auditing standards and shall include tests of the accounting and
statistical records and applicable auditing procedures. Hospitals shall be
notified of the results of the final audited cost report, which may contain
adjustments and revisions that may have resulted from the audited Medicare Cost
Report. Hospitals shall have the opportunity to request a review of the final
audited cost report. The request must be received in writing by the Department
within 45 days after the date of the Department's notice to the hospital of the
results of the finalized audit. The request shall include all items of
documentation and analysis that support the request for review. No additional
data shall be accepted after the 45 day period.
f) Hospitals described in Section
148.25(a)(1) and
(a)(2) shall be required to submit outpatient
cost reports to the Department within 150 days after the close of the
facility's fiscal year.
