2014 HAR Education and Information Session Jonathan Peters, MHA Lucas Hovila, MHA Tracy Johnson, MDH Cara Bailey, MDH
2014 Education and Information Topics Capital Expenditure Hospital and System Level Reporting Changes to the 2014 Formset & Extension Requests Provision for Bad Debts Clinic Reporting on the HAR Reminders, Resources, and Tips Medical Care Surcharge Estimator
Capital Expenditures A Guide to Minnesota Capital Expenditure Reporting
Reporting Requirements There are two separate reporting requirements for Capital Expenditures: Reporting of major capital expenditure commitments for each project greater than one million dollars (see HAR sections 56 & 57) Providing sufficient project specific information about capital expenditure commitments for MDH to complete a retrospective review of each project.
Reporting Forms Providers submit capital expenditures on existing annual financial reports Hospitals - Hospital Annual Report (HAR) Surgical Centers Freestanding Outpatient Surgical Center (FOSC) Report Imaging Centers - Diagnostic Imaging Facility Report Physician Clinics or Clinic Systems System Capital Expenditure Report Health Care Systems - Capital Expenditure Report
Health Care Systems Decision Chart
Capital Expenditure Reporting What s New? Formset Changes Retrospective Review Portion Project Update Reporting Minimize Duplications
Formset Changes Retrospective Review Information is now on ONE page Encourage succinct narrative answers Drop down menus to identify project types
Project Update Reporting If your project has been reported previously, it does NOT need to be updated or re-reported UNLESS there has been a significant change in scope and budget.
Project Update Reporting We have added a tab in the 2014 HAR Formset titled Prior Cap Exp Report. Please be sure to check this tab to ensure any capital expenditure projects have not been reported in a previous year.
Project Update Reporting The Prior Cap Exp Report tab has room for 20 previous projects.
Project Update Reporting When reporting significant changes be sure to include: Specific references to the original project Explanations in the narrative portions of the Retrospective Review section that clearly describe the changes being made to the project Only NEW commitment dollars
Use of Capital Expenditure Information Capital expenditure information is used by MDH to fulfill statutory requirements to review major spending commitments by hospitals and other providers MDH also uses capital expenditure data to produce informational documents to inform the public on spending trends
A Capital Expenditure Contact is required by all hospitals. This should list the individual responsible for any questions relating to Capital Expenditures. Capital Expenditure Contact Information The Capital Expenditure Contact is required, and is not optional.
The 2014 HAR Formset and Extension Request Information A run-through of the changes made to the 2014 HAR Formset and a reminder about requesting an extension.
2014 Formset Changes There are a few changes to the 2014 HAR Formset. The changes include the formatting of the Payer pages, the employee classification section and the Capital Expenditure tab (which has already been discussed).
Changes to Payer Pages The HAR used to group payers by Non-Managed Care and Managed Care, but now groups payers by Medicare, MA/PMAP and MNCare.
Change to Employee Classification In the Employee Classification Sections (Sections 27-29), X-Ray Technician has been replaced with Imaging Technician. This change was made because the field of Imaging has greatly expanded and many of the technicians were being included with All Other Personnel.
Extension Policy For the 2014 HAR, MHA is able to grant an initial extension of 21 days. If a hospital is 30 days late submitting their HAR, the hospital will be turned over to MDH.
Extension Requests Increasingly, the legislature and the public are looking for more up-to-date information from government. MDH wants to work with MHA and hospitals on reducing the need for data filing extensions beyond the initial 21 days. We hope MDH will need to grant longer extension requests only in the most extreme cases, where sticking to the timeline would pose and undue hardship on hospitals or compromise the quality of the report.
Extension Requests In FY 2013, 50% of hospitals asked for an extension. Of the 50% of hospitals that asked for an extension, 20% of hospitals asked for an extension of 30 days or greater.
Clinic Reporting Reporting Guidelines for Clinic Information on the Hospital Annual Report
Clinic Decision Flowchart
Offsite Locations Tab All outpatient departments, clinics, and components not located on the hospital's premise Offsite locations where services provided are billed under the hospital's Medicare and Medicaid provider numbers Verified against hospital license application
Offsite Locations Tab Reminder: This tab is matched against Gross Clinic Charges (account 0207) and Other Institution Charges (account 0208). If there is an offsite entity being listed in account 0207 and/or 0208, please list these entities on the Offsite Locations Tab. For each entity that is listed on the Offsite Locations Tab, please fill out all data fields.
Provision for Bad Debts Reporting Guidelines for Provision for Bad Debts
Reporting Provision for Bad Debts This is just a reminder of the change that was made to the 2013 HAR. Due to a change in Financial Accounting Standards Board (FASB) rules, Provision for Bad Debts is now included in Total Adjustments and Uncollectibles.
Reporting Provision for Bad Debts Please note that since Provision for Bad Debts is reported as an adjustment it will be reported as a negative number.
Institution Reporting for Provision for Bad Debts For the Institution Section, Provision for Bad Debts will be reported in account 0216 and included in Total Adjustments and Uncollectibles (account 0220).
Hospital Only Reporting for Provision for Bad Debts Provision for Bad Debts for the Hospital only will be reported in account 0739 and included in Total Adjustments and Uncollectibles (account 8063).
Change to Section 14: Primary Payer Adjustments & Uncollectibles Provision for Bad Debts along with breakout accounts for Hospital Patient Care Services and Other Patient Care Services is now automatically reported on page 7 of the HAR in Section 14. These are auto-calculated cells.
Reminder If your hospital chooses to provide internal numbers and not use the formulas in Sections 23-26, please be sure to include Provision for Bad Debts in the Adjustments on the schedules.
For example in Section 23, now that Bad Debt is reported as an adjustment, Physician Bad Debt needs to be included in Physician Adjustments (account 5503). Example
Reminders, Tips, and Resources for Preparers General Guidelines and Places for Further Information
Medical Care Surcharge Estimator A Medical Care Surcharge Estimation Tool has been included on a separate tab in the HAR 2014. After completing the HAR, please review this tab to verify that the information reported on the HAR for these key accounts is accurate. DHS remains the sole determiner of your surcharge, and this tool is to be used only to give guidance and help in the correct completion of the HAR.
MCR and Audited Financial Statement Submission MHA has the ability to receive the Medicare Cost Report in the ECR file format. ECR format is the preferred format for the MCR. Your hospital s AFS and MCR should be submitted as soon as they become available.
Data Transmission Method Available HTTPS data transmission available Transmission encrypted and secure As easy as web e-mail or online banking Hospitals can download their prior year s Commentary or Hospital Profile report from same site as well. More safe and secure than postal mail or e-mail No file size restrictions, unlike e-mail This method is highly recommended by MDH and MHA for data transmission Please contact MHA to receive your login and password Web address: https://har.mnhospitals.org
Places for Further Information Both MDH and MHA s website have further information on HAR related issues. MDH Website: http://www.health.state.mn.us/divs/hpsc/dap/hccis/index.html MHA Website: http://www.mnhospitals.org/data-reporting/mandatory-reporting/health-care-costs-informationsystems-hccis All Deadlines and Events are posted on websites. Power Point presentation of 2013, 2012, 2011 and 2010 HAR Education and Information Sessions available at sites above. Electronic Newsletters covering the following topics: Getting Started Microsoft Excel Tips and Useful Tools Expense Allocation Methodology Primary Payer Charges and Adjustments Outpatient Charges If a question or problem arises while completing the Hospital Annual Report, please contact Jonathan Peters or Lucas Hovila at MHA or Tracy Johnson at MDH (see last slide for contact information).
Contact Information MHA staff at (800) 462-5393 or (651) 641-1121 Jonathan Peters, MHA (651) 659-1422, jpeters@mnhospitals.org Lucas Hovila, MHA (651) 603-3536, lhovila@mnhospitals.org Tracy Johnson, MDH (651) 201-3572, Tracy.L.Johnson@state.mn.us