Tenn. Comp. R. & Regs. 1200-13-09-.04 - COST REPORTS REQUIRED

(1) In order to be eligible for payment by the Medicaid program for hospital services provided to Tennessee Medicaid beneficiaries, providers, including those paid by a prospective method, are required at each provider's fiscal year end, upon termination of provider status, change in ownership, or enrollment as a new provider, as per Rule 1200-13-9-.11, to submit to the Comptroller of the Treasury an annual cost report on forms designated by the Department. This report shall be submitted not later than three months from the end of each provider's fiscal year. Such cost reports must be completed in accordance with the Medicare principles of cost reimbursement set out in the Medicare Provider Reimbursement Manual, in effect on October 1, 1982, except where the Department may specify otherwise by these rules.

(2) Providers which fail to submit cost reports which comply with Title XVIII principles in effect on October 1, 1982 and described at 42 CFR Part 405 shall be subject to penalties imposed by such regulations. Except as stated in Rule 1200-13-9-.07(3), hospitals not filing cost reports for a specified period shall be required to refund all payments made under this program for that period.

(3) To be eligible to receive payment, contracting hospitals shall use uniform hospital statistics and classification of accounts as published by the American Hospital Association for all accounting records, or any other acceptable accounting methods approved by the Department of Health and Environment in consultation with the Comptroller and the Tennessee Hospital Association. However, accounts, statistics and records pertaining to "medical indigents", "bad debts" and "charity" shall be classified as defined by T.C.A. § 68-1-109, as amended by Chapter 319 of the Public Acts of 1987.

(4) After a period of five years following the implementation of the TennCare Program on January 1, 1994, amended or corrected hospital cost reports with claims for reimbursement for services prior to January 1, 1994 shall not be accepted.

Notes

Tenn. Comp. R. & Regs. 1200-13-09-.04

. Original rule filed June 2,1988; effective July 17, 1988. Amendment filed October 14, 1998; effective December 28, 1998.

Authority: T.C.A. §§ 71-5-105, 71-5-109 and 4-5-202.