Medicare Subsection d

When will a Medicare Subsection (d) Hospital be paid?

Upon submission of a successful attestation of meaningful use, the hospital will be eligible for an EHR incentive payment. The hospital will receive a preliminary, initial payment soon after attestation (usually within 4 to 6 weeks). The initial payment will be calculated based on the data reported on the hospital’s latest submitted 12-month cost report.
Final payment will then be determined at the time of settling the first 12-month hospital cost report for the hospital fiscal year that begins on or after the first day of the payment year. Preliminary payments will be reconciled to the actual amounts at final settlement of the cost report.
Example – A hospital has a December 31 fiscal year end, and attests as a meaningful user on August 1, 2011. At the time of such attestation:
The latest filed cost report will most likely be the fiscal year end December 31, 2010 cost report. Data from that cost report will be used to calculate the initial payment (subject to review by the Medicare contractor).

Final payment will be based on data from the fiscal year end December 31, 2011 cost report. This is the first 12-month cost reporting period that begins in payment year 2011 (which is Federal fiscal year 2011). These data will be used to “reconcile” the initial payment, at final settlement of the cost report.
The new Medicare hospital cost report, Form CMS 2552-10, will contain worksheets to accommodate the EHR incentive payments.
Note – the EHR incentive payments will be made by a single payment contractor, and not by the hospitals’ Medicare contractor (Fiscal Intermediary/Medicare Administrative Contractor).
For more information about the Medicare and Medicaid EHR Incentive Program, please visit

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