SFY 2020 DSH FAQs

Yes. Per Nevada Administrative Code, each hospital that is not solely a psychiatric hospital, regardless of eligibility to receive DSH payments, must complete the OB and MIUR surveys annually.

Yes. Per Nevada Administrative Code, each hospital that is not solely a psychiatric hospital, regardless of current Medicaid enrollment status or utilization, must complete the OB and MIUR surveys annually.

On the SFY 2018 DSH Eligibility page under Resources, there is a link to a DSH Submission Status Report.  This report is updated weekly to reflect all submissions received by DHCFP.

Yes. Per Nevada Administrative Code, each hospital that is not solely a psychiatric hospital, regardless of current Medicaid enrollment status or utilization, must complete the OB and MIUR surveys annually.

MIUR surveys should be submitted electronically to DHCFP using DocuSign.  See below for additional FAQs relating to the DocuSign process.

On the SFY 2018 DSH Eligibility page under Resources, there is a link to a DSH Submission Status Report.  This report is updated weekly to reflect all submissions received by DHCFP.

No. When a hospital has an HBSN they should back the SNF & Swing Bed days out of Medicaid and Total Days.  This is true for the uncompensated care templates (UCCR) as well as the MIUR.   

It depends if it's a part of the hospital or not.  For example, subprovider rehab days should be included, but rehab days as part of a Clinic or RHC should not be included.

No. Only hospitals that qualify as a disproportionate share hospital pursuant to 42 U.S.C. § 1396r-4 are required to submit the LIUR survey.

LIUR surveys should be submitted electronically to DHCFP using DocuSign.  See below for additional FAQs relating to the DocuSign process.

On the SFY 2018 DSH Eligibility page under Resources, there is a link to a DSH Submission Status Report.  This report is updated weekly to reflect all submissions received by DHCFP.

Yes, the Charity Care on the LIUR template should be reported for Inpatient services only. 

Yes, but only the Medicaid portion of the payment. What we are attempting to capture in Line 6 is the total amount paid to the hospital for patient services under a State Plan, per 42 U.S. Code § 1396r–4 (b)(3)(A)(i)(I).Payments from NV Medicaid are captured on lines 1, 2, 3, & 5, and line 4 is intended to capture Medicaid payments from other states (as they too would have a State Plan under which those payments were made). Payments from NV Medicaid for Dual Eligible recipients are still payments made under the State Plan, so they should be included in lines 1 and 3. However, since Medicare and patient payments are paid outside of the State Plan, those portions of the payment should be excluded from the LIUR calculation.

No. Hospitals that do not qualify as a disproportionate share hospital pursuant to 42 U.S.C. § 1396r-4 are not required to submit the UCCR.

Audited cost reports should always be used if they are available.

For an individual to be considered Uninsured, the individual must not be Medicaid eligible and must be an individual with no health insurance or other third party coverage. Per the CMS Final Rule issued 12/3/2014, Uninsured status is determined based on the Service; A "service" should include the same elements that would be included for the same or similar services under Medicaid generally. The intent being that a hospital will generally determine that an individual is either insured or not insured for a given hospital stay, and will not separate out component parts of the hospital stay based on the level of payment received.  if it is a Medicaid-covered hospital service, but the individual's insurance doesn't cover it, it may count as Uninsured. Individuals with exhausted insurance benefits at the time of service, individuals who have reached lifetime insurance limits for certain services, and individuals whose benefit package does not cover the hospital service received (must be a covered service under the Medicaid State Plan) may also be considered Uninsured for the purpose of the UCCR.

Bad debt is term used for an account that has been deemed to be uncollectible by a hospital.  Bad debt status has no bearing on the determination of uninsured.

Charity is based on hospital policy that states the income level that a hospital determines that an account should be pursued.  Charity care has no impact on whether an account is uninsured.

Improper billing by a provider does not change the status of an individual as uninsured if otherwise covered.  In no instances should costs associated with claims denied by a health insurance carrier for such a reason be included.

Inpatient Public UPL, Outpatient Public UPL, Inpatient Private UPL, GME, and IAF supplemental payments applicable SFY 2016 must be reported on the UCCR, Line 18.  Retro payments received in a different SFY, but applicable to SFY 2016 must be reported.  Nevada Medicaid DSH payments are excluded.

The MCO reports used for DSH UCCRs are typically delivered to DHCFP in mid-May.  Until the MCO reports are available, facilities may use internal reporting; DHCFP will check for reasonableness upon receipt of the applicable MCO reports.  Adjustments, if necessary, may be requested by the hospital or DHCFP prior to finalizing the DSH distribution calculation.

Facilities are strongly encouraged to use the CRS data to file their UCCR.  However, the hospitals should be eliminating any non-reimbursable or non-hospital days and charges to get to their filed amounts.  The CRS data does include professional fees in total charges, but since they are non-reimbursable, these charges for professional fees should be excluded in the UCCR’s reported charges.

The Preparer/Contact Person is the person actually completing the form.  He or she will enter all responses on the survey, but will not have the ability to sign the form. Upon completion of the survey responses by the Preparer, an email will be sent to the Authorized Signer with a link to the prefilled document requesting their signature.

This will be the facility’s signer.  This person will not have access to enter responses; He or she will simply review the previously entered responses and offer a digital signature.  Upon signing, a copy of the completed form will automatically be sent to the Authorized Signer and to the appropriate DHCFP staff.  There is no need to submit the surveys via any other method.

If one person will be fulfilling both roles (Preparer and Signer), please enter the same name and email in both areas when prompted.  He or she will then complete the process in the two steps outlined for each role.

DocuSign will give the Preparer the opportunity to download the form after they fill out all responses, but it will not yet have the authorized signature.  Once received and logged, DHCFP will send a copy of the completed form to the Preparer (if the Preparer is a person other than the Authorized Signer),