Medicare Cost Report Issues Examined

Created by Ben Fredricks, Modified on Sat, Dec 28, 2024 at 9:38 PM by Ben Fredricks

Related to Product: SectyrHub 340B

Applies to: Service Providers, System Users, Covered Entity Users

Description: This article explains the ways in which issues are represented within the Medicare Cost Report (MCR) workflows accessed from the Covered Entity level.

Issues are created based on rules-based logic built into the solution. Issues can be related to missing coverage regarding a requirement workflow, or they can be specific to a workscreen.

The following table lists out all issues you may encounter regarding the MCR:

Issue Name	Where it is Found (when present)	Cause and Resolution
Missing Coverage	MCR listing page > Missing Coverage table	When no workscreen has been created, or when the previous workscreen reaches the Next Expected Filing date, an issue will be created, prompting the user to add a new workscreen for the newly filed cost report and its related information.
Draft Documents Exist	MCR listing page > workscreens table > right column, workscreen-specific	When a document is left in a draft state, an issue is created to prompt users to get the document to a finalized state. If the document is complete, update the status to Final. If a new version of the document is needed, update as necessary and mark as Final once complete.
No Document Marked as Original	MCR listing page > workscreens table > right column, workscreen-specific	When no documents are marked as Original (meaning the original document rather than an amendment), an issue is created. Each workscreen will require a document labeled as Original Final.
Ineligible DSH Percentage	MCR listing page > workscreens table > right column, workscreen-specific	When the DSH percentage entered is lower than the required DSH percentage for the entity type, an error will be created to prompt the user to confirm the percentage. If the percentage reflects what is in the cost report and the issue remains, reach out to your leadership team immediately for the next steps. The covered entity should cease buying 340B drugs if the DSH percentage is below the required threshold.
Cover Page Not Signed	MCR listing page > workscreens table > right column, workscreen-specific	When the “Cover Page Signed” checkbox is left unchecked, an issue will be created. The user must confirm that the agreement has been signed by the appropriate parties prior to checking the box. This may require uploading the signed cover letter separately. Many entities accept e-signatures.
Unconfirmed Control Type	MCR listing page > workscreens table > right column, workscreen-specific	When the control type within the cost report has not been confirmed against the control type set by your system administrators, an issue is created. If the control type does not match (or needs to be set) reach out to your 340B leadership to confirm the control type set for your covered entity. Certain control types may impact 340B eligibility. Once confirmed, update the dropdown to reflect that the control type matches as anticipated.

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