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Tag: PS&R

Potential Issues with PS&R Report 118 Medicare Days

We have observed issues with the Medicare Managed Care days from PS&R Report 118, while working with numerous providers on recent cost report filings. We recommend all providers review any recently generated PS&R summary reports to ensure there are no issues with the Medicare Managed Care days from PS&R Report 118 and potentially re-run new PS&R summary reports to correct any issues.
CMS recently released 05.15.02, addressing PS&R Enhancement 1319 (PS&R updated to purge Rejected claims in conjunction with CR 12251). The following is a description of the issue/resolution:
“Prior to 10/4/2021, FISS was sending rejected claims to PS&R in the Paid Claim File (PCF). The rejected claims caused discrepancies between the Medicare Days and Accommodation Units on the PS&R 118 Report which in turn had the potential to cause an overstatement of Medicare Days on provider cost reports. Due to this problem, CMS issued CR 12251, instructing FISS to no longer send rejected claims to PS&R (with exception of certain RAC PIP non-paid claims). FISS implemented this CR on 10/4/2021 which resolved the issue for prospective claim loading/reporting into PS&R. However, the historical rejected claims which were loaded into PS&R still needed to be purged (made to no longer be reportable) such that they no longer caused the discrepancy described above on PS&R reports. With the implementation of this enhancement, all Rejected claims have been purged from PS&R reporting.”
Please reach out to Matthew Beymer at or Sherry Collins at for any additional cost report questions. They can also be reached at (888) 514-9312.
Thank you,
Toyon Associates, Inc.
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IACS – Migration of IACS Services to EIDM

From: HFS Software News Release – 1/23/15

Health Financial Systems Note:

CMS posted the following to their website regarding a switch from IACS to EIDM (Enterprise Identity Management System) which is to take effect February 7, 2015.  The important thing to know is that no new registrations or profile changes can take place in IACS after 5 pm. on January 30, 2015.  PLEASE READ and take appropriate action.

CMS Post:

This important message applies only to current users of the following applications: Bundle Payments EFT, COB, CPCi, CSR, ECRS, Gentran, HPG, Internet Server (TIBCO), MAPD (MARx UI), MDR, MED, myCGS, Novitasphere, PS&R, STAR, The SPOT (FCSO) and VMS CL IACS Services for your application will be moving to the Enterprise Identity Management System (EIDM) on February 9, 2015. In preparation for the move no new user registrations or profile modifications will be accepted after 5:00 PM on January 30, 2015.

What you should DO!

  1. DO make sure that you know your User ID and Password. Your User ID and Password will be moved “as is” on January 30 after 5:00 PM. You should be certain that you know your User ID and Password AND that you can successfully login to IACS before 5:00 PM, Friday, January 30, 2015.
  2. DO reset your password if you think that your password might expire between January 30 and February 9, 2015.
  3. DO work with your Application Helpdesk to get any pending request approved before 5:00 PM, Friday, January 30, 2015.
  4. DO review your profile and ensure that all information is correct prior to 5:00 PM, Friday, January 30, 2015.

What you should NOT do!

  1. DO NOT register for a new User ID in IACS if it cannot be approved prior to 5:00 PM, Friday, January 30, 2015
  2. DO NOT register for a new User ID in EIDM! This will only complicate moving your IACS User ID to EIDM!
  3. DO NOT make changes to your user profile or submit a request of any type that cannot be approved prior to 5:00 PM, Friday, January 30, 2015.

PS&R and STAR Security Officials: If you are requesting the IACS Security Official (SO) role, please note, that your request will expire if the required IRS documentation is not submitted within 60 days of your request. Allow time for processing and if you know that your request will expire, please contact EUS before the 60 day deadline.

Do not disclose or lend your User ID AND/OR PASSWORD to someone else. They are for your use only and serve as your electronic signature. This means that you will be held responsible for the consequences of unauthorized or illegal transactions. Sharing of accounts may lead to termination of system access privileges and /or adverse action up to and including legal prosecution.

IACS – Migration of IACS Services to EIDM

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Medicare Cost Report Preparation

We (Toyon) are at the peak of our cost report preparation cycle for FYE 12/31/13 hospitals.   There are a couple of preparation issues we came across that we want to make you aware of:

  • Medicare PS&R – Other Adjustment

We found that for several of our hospitals, there is an “Other Adjustment” reduction to reimbursement (See below):

In our follow-up, we spoke to Luke Disabato from HFS who filled in the mystery of the amounts in this field.  Luke shared that when the sequestration was first implemented, there was some communication that the sequestration was being specifically applied to the Outliers and therefore reflected 98% of the actual Outlier amount in the PS&R.  The PS&R systems staff to correct this grossed up the Outlier amounts by 2%.

It turns out that the Outliers were not actually reduced so that for a time the Outlier reimbursements on the PS&R are actually overstated.  The “Other Adjustment” was used as the other side of the entry to effectively reduce the Outliers to 100%.

Luke recommended for cost report filing purposes, that these “Other Adjustments” be summarized into the Outliers line of the cost report.  We (Toyon) have chosen to simply record this “Other Adjustment” on Line 70 of E Part A with a description of “Corrected Outlier” for our cost report filing.

One word of caution, there are certain MACs where the “Other Adjustment” for services on or after October 21, 2013 that contains the DSH Uncompensated Care payments.  We have not found this to be an issue for Noridian Healthcare Solutions and Luke informed us that this was also not an issue for NGS.

We appreciate Luke’s help in clarifying this issue.

  • Bi-Weekly Payments (Noridian) Change

The bi-weekly payment summaries that have been issued by Noridian do not include any beginning or ending accrual.  This is a change to how the bi-weekly payments have been handled in California.  In our follow-up with Noridian, they confirmed that they do not plan to include any beginning or ending accruals for these bi-weekly amounts.

However, they do realize that for the prior cost report filing there was an accrual at the end of the year.  So the treatment for the FYE 12/31/13 cost reports that Noridian is now managing is to include the beginning of the year accrual based on the split from the prior year cost report but there will be no yearend accrual.

Here is an example to hopefully make this handling clearer:

FYE Description


12/31/12 YE Accrual

(4/14) x $140,000 = $40,000


12/31/13 Beg Accrual

(10/14) x $140,000 = $100,000

12/31/13 Total (26)Bi-Weekly Payments

26 x $140,000 = $3,640,000

12/31/13 Total For CR Filing


The beginning accrual will be made only for the first year.  All future cost report years will be simply the 26 bi-weekly payments without accruals.


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Toyon Associates Healthcare Finance


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