Los Angeles County Department of Mental Health FY 2020-21 Cost Report Training
This training session by Sara Dato, Tracy Namkung, and Christina Liu from the Financial Services Bureau, Reimbursement & Audit Support Division provides essential information for contractors on the FY 2020-21 Cost Report submission. It covers important dates, DHCS updates, and training objectives. Contractors are guided on how to complete the report, given contact information, and informed about deadlines and extensions.
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LOS ANGELES COUNTY LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH DEPARTMENT OF MENTAL HEALTH FY 2020-21 COST REPORT TRAINING Present by: Sara Dato Tracy Namkung Christina Liu 1 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Housekeeping + Opening Remarks Housekeeping + Opening Remarks Welcome Microphones are muted Q&A at the end of training as time permits This session is being recorded. The recording and PowerPoint will be posted on the DMH Cost Report training website: https://dmh.lacounty.gov/for- providers/administrative-tools/cost-report-training-materials/ 2 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Training Objectives Training Objectives Provide the important dates of the FY 2020-21 Cost Report Timeline. Provide updates from DHCS Ensure contractors understand how to complete the FY 2020-21 Cost Report Provide Cost Report Contact Information. Answer questions 3 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Important Dates Important Dates August 30, 2021 - Cost Report submission Extension Request deadline: Provide written justification and length of time needed to submit. Submit extension requests to CostReportMailbox@dmh.lacounty.gov Email Subject: Request for Extension to FY 20-21 CR Deadline CONTRACTOR NAME Written approval of extension must be received from DMH in order to be considered granted. September 30, 2021 - Deadline to submit FY 2021- Cost Report Package: CR must be received by the CR Section by 5:00 p.m. on September 30, 2021. 4 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Important Dates, Cont. Important Dates, Cont. October 1, 2021, or the next day after the extended deadline: Assessment of $100 per calendar day will be incurred for late fee until CR is received. October 29, 2021: Deadline to submit requests for the FY 2020-21 Final Shift of Funds Amendment. 5 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
DHCS Updates DHCS Updates The DHCS training date is not decided yet. We will post FY 2020-21 Cost Report Template on the training website once it s ready from State and inform all contractors. Lower of Cost or Charge Medi-Cal reimbursement principle will continue to be waived for FY 2020-21 due to COVID 19 pandemic. 6 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Changes in FY 2020 Changes in FY 2020- -21 Cost Report Lower of Cost, CMA or Charge Medi-Cal reimbursement principle will continue to be waived for FY 2020-21 due to COVID 19 pandemic except for psychiatric inpatient hospital services. Federal Medical Assistance Percentages (FMAP) carry forward from FY 2019-20 March June Period, except for Enhanced Children Medi-Cal and Medi-Cal Access Program effective Oct, 2020. (See MH 1979 of the CR template for details) 21 Cost Report 7 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Changes in FY 2020 Changes in FY 2020- -21 Cost Report, Cont. 21 Cost Report, Cont. Continuum of Care Reform (CCR) for Short-Term Residential Therapeutic Program (STRTP) Example - If the contractor provides mixture of services, it should have one line with CCR for STRTP service, and another line with CR for other regular services. 8 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Changes in FY 2020 Changes in FY 2020- -21 Cost Report, Cont. 21 Cost Report, Cont. State Fund Beneficiaries settlement group on MH1901B It includes SB-75 as well as other beneficiaries with unsatisfactory immigration status that the State pays for. SB-104 which expanded SB-75 up through age 25 claims reported under SB-75 Payor in the 701UP Report. The total regular SD/MC and Medi-Medi Crossover units of services are combined in SD/MC units of services. 9 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
New Revenue/Funding Types This Year New Revenue/Funding Types This Year Coronavirus Aid, Relief, and Economic Security (CARES) Act o May only be used to cover costs that are necessary expenditures incurred due to the public health emergency with respect to the COVID-19. Children s Outreach Triage Team (COTT) and Adult Outreach Triage Team (OTT) o Services provided under OTT and COTT programs shall be based on actual costs consistent with cost reimbursement methodology. o The UOS and cost need to be entered in Attachment 11. o Do not include UOS in total UOS count for SMHS. o Total cost should be direct charge. 10 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
New Supplemental New Supplemental Schedule Schedule 11 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Attachment 11 Attachment 11 If the contractor received funding for the OTT/COTT program, complete Attachment 11. 1. Please report Claimable Costs in the highlighted red boxes above. 2. Mode and SFmust type in 2 digits in text format. Ex: 04 3. UOS: Report Total UOS, MC UOS by settlement group and time period, and non-MC UOS. 4. Allocated Cost: Report Allocated cost by each Mode and SF. 12 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Paycheck Protection Program Paycheck Protection Program Providers that received a loan through the Paycheck Protection Program needs to enter the amount of the loan spent on eligible activities from the costs in MH1961 or MH1962. 13 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Cost Report Forms Cost Report Forms HOSP Settlement Type HOSP Settlement Type 14 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
MH1960_HOSP & MH1960_PHYS FORMS MH1960_HOSP & MH1960_PHYS FORMS In order to complete the MH 1960_HOSP_COST form, Hospital LE must first complete the CMS 2552, Hospital and Hospital Health Care Complex Medicare or Medi-Cal cost report; A hospital that does not submit a CMS 2552 to CMS and/or DHCS must at least complete worksheets A, A6, A7, A8, A8-2, A8-4, and worksheet B, Part I of the CMS 2552; Below are the forms used to apportion the hospital cost and the physician cost for the Medi-Cal services by Mode 05, Mode 05 Admin Day, Mode 10 and Mode 15. MH1960_HOSP_COSTS MH1960_HOSP_10 MH1960_HOSP_05 MH1960_PHYS_10 MH1960_PHYS_05 MH1960_HOSP_15 MH1960_HOSP_05_ADMIN MH1960_PHYS_15 MH1960_PHYS_05_ADMIN 15 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Hospital Costs Non Hospital and Hospital costs also reported separately in LAC101 SD/MC Inpatient Hospital Costs are computed using MH1960_Hosp Forms State of California Health and Human Services Agency 1 2 3 DETAIL COST REPORT CALCULATION OF MODE 05 (HOSPITAL PSYCHIATRIC INPATIENT) PROGRAM COSTS - HOSPITAL LEGAL ENTITIES MH 1960_HOSP_05 (Rev. 02/2019) Salaries and Benefits Total Cost HOSPITAL LEGAL ENTITIES Other County Code: 19 Hospital Modes Costs (MH 1901 Schedule C Total Hospital Costs) 394,283 285,516 679,799 Legal Entity Number: 00050 Example: Units per Costs for Hospital Units and Costs 1 2 3 Cost per Day/Cost to Charge Ratio SD/MC SD/MC Costs Settlement Type Mode SF Total Units HOSP HOSP HOSP Total Allocated Cost 411,440.00 $ 241,089.85 $ 27,269.57 $ 679,799.42 $ Cost per Unit 1,028.60 $ 803.63 $ 272.70 $ Days/Charges/RVU 05 05 05 10 15 19 400 300 100 800 07/01/2020-06/30/2021 07/01/2020-06/30/2021 Inpatient Routine Cost Centers 886.32 150 132,948 Adults and Pediatrics (General Routine Care) Intensive Care Unit - - Coronary Care Unit - - M/SFC 05/10-18: Avg. Rate $932.19 ($653,529.85/700 units) Hospital Settlement Type for Non Medi-Cal Services are reimbursed based on County Contracted Rate 16 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
SD/MC Reimbursement for Inpatient Hospital Costs Mode 05 Hospital Inpatient Services (SFC 10-18) Reimbursement Based on Actual Cost (from MH1901_Sch_C) Gross Costs based on MH1960_HOSP_ Form ** Published Charges Sett Type Mode SFC MC Units Rate Gross Costs Rate Gross Costs HOSP 05 10 50 $1,028.60 $51,430.00 $1,250.00 $62,500.00 HOSP 05 15 100 $803.63 $80,363,28 $1,250.00 $125,000.00 Total 150 $131,793.28 $187,500.00 $132,948.00 Reimbursement of SD/MC Inpatient services are based upon the lower of cost** or published charges; ** The total cost of providing Mode 05, Hospital Inpatient Services (SF 10-18) to SD/MC is equal to the sum of columns of MH1960_HOSP_05 and MH1960_PHYS_05. 17 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
SD/MC Reimbursement for Inpatient Hospital Costs (Contd) Mode 05 Hospital Inpatient Administrative Day Services (SFC 19) Reimbursement Based on Actual Cost (from MH1901_Sch_C) Gross Based on MH MH1960_ HOSP Forms** Published Charges Statewide Maximum Amount (SMA) M o d e Physician + Ancillary Costs Sett Type SF C MC Units Gross Costs Gross Costs Rate Rate Rate Units x rate Gross HOSP 05 19 20 $272.70 $5,454.00 $435.00 $8,700.00 $569.54 $11,390.80 $0.00 $11,390.80 $5,774.00 Reimbursement of hospital Inpatient administrative day is based upon the lower of cost**, published charge, or SMA; ** The total cost of providing Mode 05, Hospital Inpatient Administrative Services (SF 19) to SD/MC is equal to the sum of columns of MH1960_HOSP_05_Adm and MH1960_PHYS_05_Adm. 18 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
MH1962 - OTHER ADJUSTMENTS TO COSTS Providers that received a loan through the Paycheck Protection Program needs to enter the amount of the loan spent on eligible activities from the costs in MH1961or MH1962. 19 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
MH1969_INST MH1969_INST - - Nominal Fee Provider Nominal Fee Provider Determination Determination (Optional Form) (Optional Form) For Cost Reimbursement Type Contractor, Lower of Cost, CMA, or Charge Medi-Cal reimbursement principle will continue to be waived for FY 2020-21 due to COVID 19 pandemic. For Hospital Provider, if your PC rate is lower than the actual costs, please complete the form to find whether your LE is qualified for Nominal Fee Provider to exempt PC. 20 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
MH1991 Calculations of SD/MC Hospital Admin days To identify the amount of physician and ancillary costs associated with SD/MC hospital administrative day (Mode 05, SFC 19) for use on the MH1966. Only applicable to settlement type HOSP with 24 hours services. Admin days entered should match the number of Medi-Cal units reported on MH1901_Sch B for Mode 05, SFC 19. LE should also enter the Physician and Ancillary cost to the corresponding columns to populate total cost. 21 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Common Problems Noticed During Desk Common Problems Noticed During Desk Review Review Published Charge: Customary schedule of charges to the public for clients in need of SMHS. Each contractor has its own rates and may not use the County s CMA Rate which is different than its own. Provisional Rate: Interim reimbursement/billing rate for SMHS, not used for PC Total units: may include any unbilled services. If you include unbilled services in the Total Units, ensure to submit these services to the County in order to reflect on the County Chief Information Office 701U-P Report. Units of Service Reconciliation: Total units and Medi-Cal units are reconciled periodically (Monthly or Quarterly). If any variances are found, it should be resolved with Central Business Office (CBO). MH1901 B: Enhanced FMAP Non-CHIP (Aid Code E2, E4, E5) and Enhanced FMAP CHIP (2 different periods in Cost Report) SFC in MH1901 B needs to be 2 digits and in TEXT format. 22 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Common Problems Noticed During Desk Common Problems Noticed During Desk Review, Cont. Review, Cont. Community Outreach Services (COS) UOS and Case Management Support (CMS) Services are in minutes in 701 UP. The cost report requires Mode 45 and CMS in Hours. For Mode 60 and SFCs 70, 71, 72, 75, & 78 services, put enter 1 in MH1901 B Total Unit column. Attachment 9A: All direct charge has to be reconciled with the payment received from County Attachment 10A: Each Medi-Cal revenue by settlement group in 10A must match with MH1901 B. Total revenue in 10A must match with LAC103. Attachment 10B: EPSDT Units should be within Medi-Cal units by each Mode and SFC, by settlement group, and funded program. County will use CBO Bulletin No. NGA 20-011 for local match requirement: EPSDT and MCHIP MEDI-CAL. Crosscheck and make necessary corrections for any ERROR messages displayed in LAC102. 23 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Documents to be included with Cost Documents to be included with Cost Report Submission Report Submission 11 OTT_COTT Costs and Units Complete 11 if the contractor received funding for the OTT/COTT program. Every Legal Entity/Agency must submit a Cost Report, Attachment 4 and 4A. 4 Cost Report Letter of Certification* Supporting Documents: 4A Source of UOS data (Contractor s internal records or 701- UP with run date)* Client Units of Service Reports (if the LE is using internal records) LE needs to submit Attachment 9A, 10A, 10B, or 11, if applicable. Third Party Revenue Records 9A Non MC Direct Charge expenditures by funded program* Indirect Cost Allocation Plan Complete 9A for manual invoices. Fixed Assets Depreciation Schedule 10A Third Party Revenue by funded program & payor source* Trial Balance Sheet Complete 10A if LE fills in 3rd party Revenue in Sch. B and LAC 103. Invoice payment logs (Special program payments) 10B Source of EPSDT data and SGF computation schedule* Complete 10B if LE chooses to use internal records to calculate UOS in 4A. 24 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
How to Submit the FY 2020 How to Submit the FY 2020- -21 Cost Report The deadline to submit the FY 2020-21 Cost Report is September 30, 2021, or as otherwise approved by County. Due to COVID 19 condition and move to new Headquarter, we will accept the electronic copies via email this year. o Email complete Cost Report package to your assigned cost report analyst. o Reference Attachment 2 for submission details. 21 Cost Report 25 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Cost Report Desk Review Cost Report Desk Review What s the next step after Contractors submit the original Cost Reports? o Cost Report Analysts will notify Contractors on concerns and/or request for corrections via email. o Contractors need to submit corrections as soon as possible. o The final correction on annual cost report must be signed & date and include a new Cost Report Letter of Certification. The complete Cost Report Analysts assignment list can be found in the DMH Cost Report training website. https://dmh.lacounty.gov/for-providers/administrative-tools/cost-report-training- materials/ 26 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Final Shift Final Shift If agencies need to request final shift, please submit final shift change request to Myles Kang at fsb@dmh.lacounty.gov within 30 days after the cost report submission deadline/extended deadline if approved. 27 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Cost Report Revisions Cost Report Revisions You will have an opportunity to submit revised Cost Reports prior to the DHCS commencement of the SD/MC reconciliation and CR Settlement process. For the revision of prior year cost reports, please contact Tracy Namkung @ Settlement Section for further instructions. o Email: tnamkung@dmh.lacounty.gov 28 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Proposed DHCS Audit and Settlement Proposed DHCS Audit and Settlement Timeframe for SD/MC Cost Report Timeframe for SD/MC Cost Report As of August 31, 2021 As of August 31, 2021 Between State and County Between County and Contract Providers Medi-Cal Reconciliation (Response from LEs Must be Received By) Medi-Cal Reconciliation (To Be Completed By) Cost Report Settlement (To Be Completed By) Audit Status (To Be Completed By) Revised CR (Must Be Received By) FY Interim Settlement / Settlement 2004-05 Completed Completed Completed Formal Hearing Completed 12/31/21 12/31/21 12/31/21 12/31/21 06/30/22 06/30/22 09/30/22 01/31/23 Issue by 09/30/21; Est To Be Paid by 12/31/21 2010-11 Completed Completed Completed 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 2018-19 2019-20 Completed Completed Completed Completed 05/07/21 09/30/21 11/30/21 02/28/22 04/28/22 Completed Completed Completed 06/30/21 09/30/21 12/31/21 02/28/22 05/30/22 07/01/22 Completed Completed Completed Completed Completed TBD TBD TBD TBD Note: Update on Net Combined Settlement / Interim Settlement for FYs 2005-06 through FY 2017-18 was issued on 07/07/21 that will be estimated to be paid by 09/30/21. 07/31/21 09/30/21 10/29/21 Issue by 09/30/21; Est To Be Paid by 11/30/21 Issue by 12/31/21; Est To Be Paid by 03/31/22 Note: County is waiting for the updated Proposed DHCS Audit and Settlement Timeframe for SD/MC Cost Report and Reconciliation. 29 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Q&A Q&A Please use the raise your hand feature so we can unmute your microphone, or type your question in the chat box. If you have other questions after this session, please email your questions to the Cost Report Mailbox: CostReportMailbox@dmh.lacounty.gov Click the link below and follow the instructions to complete your mandatory Cost Report Training attendance requirement. o https://forms.office.com/g/iDxN05MMTZ o Or, scan the barcode to complete the form. 30 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
Key Contact Information Key Contact Information The Cost Report Analysts assignment list, DHCS Cost Report Instruction Manual, Cost Report template, attachments, and submission criteria can be found in the DMH Cost Report training website. https://dmh.lacounty.gov/for-providers/administrative-tools/cost- report-training-materials/ Settlement Section: Tracy Namkung tnamkung@dmh.lacounty.gov Provider Reimbursement: Ylula@dmh.lacouty.gov CIOB Helpdesk: (213) 351-1335 Financial Service Bureau (FSB): FSB@dmh.lacounty.gov Central Business Office (CBO): CBO@dmh.lacounty.gov 31 FINANCIAL SERVICES BUREAU, REIMBURSEMENT & AUDIT SUPPORT DIVISION
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