TMHP: Where Do HCS/TxHmL Providers Go To Find The Information To Complete Their Cost Reports For 2022?

HHSC’s Response to Some Of The Questions Concerning Cost Reports for 2022:

 The HCS/TxHmL Units of Service Look-up tool was created at the providers’ request to assist them in completing the 2022 cost report.  Providers have questioned whether it captures all that is needed for the cost report and if HHSC is responsible for ensuring there is an appropriate report page for providers to collect this information in TMHP and/or Texas Med Connect.

HHSC has stated that Providers may rely on their own billing records to complete their required reports in accordance with the Title 1 of the Texas Administrative Code (1 TAC) and cost report instructions, etc.  The provider must certify that the information included in the cost report is accurate. As a reference, 1 TAC Section 355.102(c) states:

Accurate cost reporting is the responsibility of the contracted provider. The contracted provider is responsible for including in the cost report all costs incurred, based on an accrual method of accounting, which are reasonable and necessary, in accordance with allowable and unallowable cost guidelines in this section and in §355.103 of this title, revenue reporting guidelines in §355.104 of this title (relating to Revenues), cost report instructions, and applicable program rules. Reporting all allowable costs on the cost report is the responsibility of the contracted provider. The Texas Health and Human Services Commission (HHSC) is not responsible for the contracted provider’s failure to report allowable costs; however, in an effort to collect reliable, accurate, and verifiable financial and statistical data, HHSC is responsible for providing cost report training, general and/or specific cost report instructions, and technical assistance to providers. Furthermore, if unreported and/or understated allowable costs are discovered during the course of an audit desk review or field audit, those allowable costs will be included on the cost report or brought to the attention of the provider to correct by submitting an amended cost report.

Regarding concerns about the data provided in HHSC’s units of service look-up tool, information letter 2023-12 clarifies:

HHSC will be updating the record of paid units of service before beginning the financial examination of the 2022 cost reports. This timing will allow cost reports to be revised based on any paid claims adjudicated after the 2022 cost report was submitted. HHSC PFD’s Cost Report Review Unit (CRRU) financial examiners will work individually with the provider and cost report preparer if there are material variances between the units reported and the updated paid claims data.

Regarding concerns about the unit totals and not reflecting units that have not been paid, information letter 2023-12 clarifies:

Providers must report, on an accrual basis, paid units of service delivered during their 2022 cost reporting period in Step 5 on the cost report. Providers should report units of service for each waiver service by the level of need delivered during their cost reporting period and paid by the time the cost report is submitted. Any units of service delivered during the cost reporting period, but not paid by the time the cost report is submitted, should be reported as a non-reimbursed unit. HCS and TxHmL providers should report all allowable costs incurred during their cost reporting period for paid and non-reimbursed units of service.

Regarding concerns about additional training or a webinar:

HHSC is incorporating training related to accessing and using the units of service look-up tool in upcoming cost report trainings and is working on publishing recorded instructions to assist providers with using the tool. A Gov Delivery will be published when this information is made available.

HHSC encourages any provider who has questions about the tool to contact HHSC Provider Finance at PFD-LTSS@hhs.texas.gov for assistance.

Regarding requests for cost report extension:

HHSC is not granting cost report extension at this time outside of the 15-day extension established in accordance with 1 TAC Section 355.111.