§ 1151.47. Annual cost reporting.

 (a)  An inpatient psychiatric facility shall complete Form MA 336 (Financial Report for Hospital and Hospital Health Care Complex Under the Medical Assistance Program of the Department of Human Services, Commonwealth of Pennsylvania) in accordance with Medicare principles at 42 CFR Part 405, Subpart D (relating to principles of reimbursement for services by hospital based physicians).

 (b)  The inpatient psychiatric facility shall submit Form MA 336 to the Department’s Office of Medical Assistance Programs by September 30 of each year. The Department may grant a 30-day extension to the September 30 due date, upon receipt of a written request from a private psychiatric hospital or a general hospital with a distinct part psychiatric unit. If the inpatient psychiatric facility participates in Medicare, a completed copy of Form HCFA-2552—Hospital, Hospital-Skilled Nursing Facility Complex and Skilled Nursing Facility Cost Report—also shall be submitted to the Department as a supplement to Form MA 336.

 (c)  The hospital’s cost report shall:

   (1)  Be prepared using the accrual method of accounting.

   (2)  Cover a fiscal period of 12-consecutive months, from July 1 to June 30, except as noted in paragraph (4).

   (3)  Include information necessary for the proper determination of costs payable under the Program, including financial records and statistical data.

   (4)  In the case of a hospital beginning operations after the start of the fiscal year, cover the period from the date of approval for participation in the MA Program to the end of that fiscal year.

   (5)  Be adjusted to remove the costs of direct care by salaried physicians and other salaried practitioners.

 (d)  For inpatient psychiatric facilities subject to cost settlement, if the total amount of MA payment for interim claims for services during the fiscal year exceeds the total audited costs, the Department will recover the overpaid amount from the provider under §  1101.69(b) (relating to overpayment—underpayment).

 (e)  The inpatient psychiatric facility shall submit requests to retroactively review or alter the Auditor General’s reimbursement certification to the Department of the Auditor General within 1 year of the date the reimbursement certification was made.


   The provisions of this §  1151.47 amended under sections 201 and 443.1 of the Public Welfare Code (62 P. S. § §  201 and 443.1).


   The provisions of this §  1151.47 adopted September 30, 1983, effective July 1, 1983, 13 Pa.B. 2796; amended July 12, 1985, effective July 13, 1985, 15 Pa.B. 2572, and will apply to reimbursement for services for FY 1984-85 for each fiscal year thereafter; amended February 5, 1988, effective February 6, 1988, 18 Pa.B. 556; amended June 16, 1989, effective immediately and applies retroactively to July 1, 1988, 19 Pa.B. 2563; amended June 18, 1993, effective July 1, 1993, 23 Pa.B. 2917; amended October 29, 1993, effective July 1, 1993, 23 Pa.B. 5241. Immediately preceding text appears at serial pages (181782) to (181784).

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