Section 148.210  Filing Cost Reports

a)         Excepting those operated by an agency of the United States government, all hospitals in Illinois and hospitals in contiguous states providing 100 or more paid acute inpatient days of care to the Illinois Medicaid Program shall be required to file Medicaid and Medicare cost reports within 150 days after the close of that provider's fiscal year.  Any hospital accredited by TJC or another Health and Human Services Approved Accreditation Organization not eligible for or subject to Medicare certification shall be required to file financial statements, a statement of revenues and expenses by program and census logs by program and financial class.  The Bureau of Health Finance may request an audit of the financial statements by an independent Certified Public Accountant (CPA) firm if the financial statements are to be used as the base year for rate analysis.

b)         No extension of the Medicaid cost report due date will be granted by the Department unless the Centers for Medicare and Medicaid Services (CMMS) grants an extension of the due date for the related Medicare cost report.  Should CMMS extend the Medicare cost report due date, the Department will extend the Medicaid and Medicare cost reports due date by an equivalent period of time.

c)         If the hospital has not filed the required Medicaid cost reports within 150 days after the close of the hospital's fiscal year, the Department shall suspend payment for covered medical services until the Department receives the required information.

e)         Cost Report Reviews

The Bureau of Health Finance shall audit the information shown on the cost reports.  The audit shall be made in accordance with generally accepted auditing standards and shall include tests of the accounting and statistical records and applicable auditing procedures.  Hospitals shall be notified of the results of the final audited cost report, which may contain adjustments and revisions that may have resulted from the audited Medicare Cost Report.  Hospitals shall have the opportunity to request a review of the final audited cost report.  The request must be received in writing by the Department within 45 days after the date of the Department's notice to the hospital of the results of the finalized audit.  The request shall include all items of documentation and analysis that support the request for review.  No additional data shall be accepted after the 45 day period.

f)         Hospitals described in Section 148.25(a)(1) and (a)(2) shall be required to submit outpatient cost reports to the Department within 150 days after the close of the facility's fiscal year.

(Source:  Amended at 39 Ill. Reg. 10824, effective July 27, 2015)