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DOH and KPMG Hold Home Care Cost Report: Lessons Learned Webinar

Last week, the Department of Health (DOH) and accounting firm KPMG held a Lessons Learned webinar on the recent 2020 Home Care Cost Report. The report is required to be completed by Certified Home Health Agencies (CHHAs), Licensed Home Care Services Agencies (LHCSAs), and Fiscal Intermediaries (FIs). DOH reiterated that the 2019 Cost Report was a pilot and the 2020 report is considered a valid reporting process. Audit work is now complete for the 2020 reporting process, and DOH is working on developing Medicaid reimbursement rates for home care. DOH will soon be announcing a webinar on the methodology for calculating rates. LeadingAge NY will be sure to apprise members of that presentation.

Members should note that KPMG and DOH have many tools and resources on the State Home Care Cost Report website and the KPMG reporting platform to help walk providers through proper reporting, as well as templates for necessary supporting documentation. The slides of the presentation are available here; the recording will be posted to the Home Care Cost Report website.

The webinar focused on a few areas of interest; members are urged to review the slides and recording for more detail.

Supporting Documentation:

  • Certain supporting documentation is not sufficient for reconciliation or determination of completeness;
  • Hardcoded Excel files, handwritten, or omitted documentation are not acceptable;
  • Reporters should upload Excel documents with tabs or formulas, not PDFs;
  • Schedule 5 includes system-generated statistical data, third party source documentation;
  • Reporters should use templates provided, which include instructions;
  • Allocation methodology – reporters should provide a crosswalk for verification;
  • Some cost reports and supporting documentation were submitted after the Nov. 15th deadline – make sure that all parties are working toward the deadline.

Cost Report Schedules:

  • Webinar clarifies confusion regarding Schedules 3 and 4;
  • Schedule 3 – agencies' total costs include all personnel and non-personnel agency costs;
  • Schedule 4 should not include any direct care personnel costs. Schedule 3 should be greater than 4;
  • Provides detail on entity types reported on the cost report in section 1.3;
  • Every entity with the same tax ID should be reported on the same cost report. If the entity was not in operation during the reporting year, do not report for that entity;
  • Clarifies how non-allowable costs should be reported;
  • Clarifies Column 4, Schedules 3 and 4, and administrative costs;
  • Medical supply costs – this will be clarified as a separate line in the next cost report;
  • Clarifies bad debt reporting;
  • Provides detail on taxes and benefits reporting within direct care and admin worker categories;
  • Provides detail on reporting of contracted services (direct care);
  • Provides detail on fee-for-service (FFS) versus managed care reporting differentiation;
  • Clarifies proper reporting of Medicaid revenue regarding Schedules 5 and 19.

General Questionnaire:

  • Policies and procedures should be provided for cost reporting preparation – methodologies, documentation files, tools, resources. Simply providing accounting methods does not suffice;
  • KPMG will create a template that providers should customize;
  • Webinar reviewed audit process regarding supporting documentation and adjustments.

DOH noted that despite the 2 percent penalty in law for failure to submit accurate reports, late filers will not incur such a penalty. LeadingAge NY will provide details on the home care rate methodology webinar when it is announced.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871