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The growing importance of an accurate Medicare S-10 worksheet


Hospital providers have been apprehensive about the accuracy and dependability of the Worksheet S-10 since its inception.  Many providers view the instructions for the worksheet, which have often changed, as ambiguous and unclear, without concise directions for charity care/Medicaid/indigent population data entry.  Based on recent declarations from The Centers for Medicare and Medicaid Services (CMS), Worksheet S-10 data will be used in the computation of Factor 3 in the calculation of hospital Medicare DSH uncompensated care payments; providers will need to get up to speed on how to accurately capture this information.


CMS has given Medicare Administrative Contractors (MACs) the approval to begin auditing Worksheet S-10 data from hospital Medicare Cost Reports retroactive to FFY 2015.  The types of information requested from MACs ranges from hospital charity care policy disclosure to case-level detail supporting charity care/bad debt amounts reported to internal ­­financial statements used to populate Worksheet S-10.  Hospitals need to ensure that these types of internal data are readily available in order to be prepared for potential for audits of their Worksheet S-10 Medicare Cost Report data.

In spite of the previous uncertainty surrounding Worksheet S-10, it has now become the only viable method for CMS to capture uncompensated care costs incurred by hospitals that treat uninsured patients.  Hospitals can surely expect to have their Worksheet S-10 Medicare Cost Report data scrutinized by their MACs going forward, marking a paradigm shift for institutions that overlooked this worksheet in the past. 

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