The Centers for Medicare & Medicaid Services (CMS) has changed the way Provider Statistical and Reimbursement (PS&R) System reports are obtained. PS&R reports are needed to complete the Medicare cost report. Traditionally, PS&R reports have been produced by fiscal intermediaries (FI) and Medicare administrative contractors (MAC) and mailed out to providers.

Now CMS has created the Individuals Authorized Access to CMS Computer Services (IACS) website and has made it the responsibility of each provider to obtain their own PS&R reports. You may have received a letter from your FI or MAC regarding this change. Any provider can register for this system at any time, but CMS is trying to stagger the influx of new users over the entire year. At this point, all providers with year-ends from January 31, 2009, to June 30, 2009, should have received notice that they should register on the new website.

Registration is not particularly quick and will require the involvement of at least two people for each provider. A security official (SO) will register the provider and then set up a user group with a user group administrator (UGA). The SO and UGA cannot be the same individual. We recommend the SO be the owner, operator or administrator of the provider, and the UGA be the provider’s administrator, chief financial officer or business office manager. Registration requires documentation be submitted to CMS and may take up to two weeks to finalize.

To begin your registration, download the Security Official (SO) New User Registration Quick Reference Guide at the following link and follow the instructions in the guide:  http://www.cms.hhs.gov/IACS/Downloads/IACS QRG SO New User Registration_2008_12_08_v.1.2.pdf

Once the SO has obtained authorization and registered the provider, the UGA must be set up. Follow the instructions in the User Group Administrator (UGA) New User Registration Quick Reference Guide, which can be downloaded at the following link:  http://www.cms.hhs.gov/IACS/Downloads/IACS QRG UGA New User Registration_2008_12_08_v1.2.pdf

Once the provider is registered and has set up a user group, you can allow access to the PS&R system to people outside the organization, such as BKD as the cost report preparer. The request to be accepted into the provider’s user group will have to be initiated by BKD and approved by the provider, so you will need to notify us once the user group has been established.

According to CMS, there will be no cost report extensions granted because the PS&R report is obtained late. Under this system, CMS has shifted the responsibility to the provider to obtain in a timely manner the PS&R report in order to complete the cost report by the due date. The MAC or FI will not be sympathetic to providers that “just did not get around” to registering on the IACS website. Also, while BKD can give some advice, we cannot register for you. In the IACS world, we can only be end users to your user groups.

Going forward we believe the IACS will be a good thing. It will allow providers to obtain summary and detail PS&R reports in a much shorter time frame. There will be no involvement of MAC or CMS personnel, and providers will be able to obtain free PS&R reports whenever they need them.

For questions or more information, please contact your BKD advisor.

The information in this BKD Health Care Update, published by BKD, LLP, one of the 10 largest CPA and advisory firms in the country, is a brief summary and may not include all details relevant to your situation. It is not intended to provide consulting advice and should not be relied on for that purpose. For a more complete discussion of this issue, contact your BKD advisor.