CHGME PP ALERT

Reconciliation Application Cycle and Deadlines and FY 2008 Resident FTE Assessment Update

Printer-friendly Alert Update (28 KB) April 9, 2008 Alert

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The FY 2008 reconciliation application will be available (online) on or about April 1^st.Additional details provided below.

FY 2008 Reconciliation Application Cycle – NEW Web Based Application

For the past year the Children’s Hospitals Graduate Medical Education (CHGME) Payment Program has been building a new web system to process your applications for funds. The web application will help reduce the use of paper and fax and minimize manual data entry.  Each of the CHGME Payment Program FY 2008 participating hospitals will complete the reconciliation application for funds via the web and make corrections to that reconciliation application, if any, electronically (no more “crossing out”, initializing and faxing changes.) 

There are only two forms that will need to be mailed in and those are the HRSA 99 and 99-3 because of the legal requirement for original signatures. The affiliation agreements, supporting documentation and Medicare Cost Report (MCR) worksheets may be sent as a PDF to SLinney@hrsa.gov or a hard copy can be mailed to CHGME Payment Program along with your signed HRSA 99 and 99-3. As in past year, the HRSA 99 and HRSA 99-3, all required attachments and documentation, and the web application have to be “postmarked” no later than May 1, 2008.

The CHGME Payment Program web application is set up just like the hard copy applications with each tab being a different page of the HRSA 99, 99-1, 99-2, 99-3, 99-4, and 99-5. Please remember to save before navigating to any other page within the application. There is a comments field within the application where you can add any comments pertaining to the reconciliation application. There are several “tips” to help you navigate and ease your processing of the reconciliation application through the web:

• If you click on anything throughout the system that is underlined it will take you to the section of the documentation guidance, the burden statements.  These are the same documents that you have been using.  The only difference is that they are on the web.

• Read, review and save the HRSA 99 and the HRSA 99-3 even if all the fields are already populated for you based on your initial applications.  These forms require original signatures and as such they need to be read, reviewed, updated if necessary before they are signed.

• Your comments concerning your reconciliation application can be entered electronically. Please take advantage of the comment area to notify the CHGME Payment Program of specific items or concerns within your application.

• Once the reconciliation application is submitted, the receipt control manager will reply with an email to let you know that the reconciliation application and all attachments have reached the program.  If any corrections are required during receipt control you will receive the same notice that you received in the past indicating missing or incomplete applications. The reconciliation application is reviewed by the HRSA Regional Manager (RM) only when a complete reconciliation application including all attachments is submitted.

• Your RM will get the same notification and will proceed to review the reconciliation applications.  If the RM identifies changes to be made the hospital will notified by Email and those changes will be made via the web applications.  The signed letter that accompanies those changes will need to be fax or emailed via PDF.  Once the RM has completed the review, and the Chief of GMEB finalized the review, the children’s hospital will receive an email indicating the end of the review process.

• As in the past, please take note that the award letters and vouchers for funding will go to the person identified on line number two of the HRSA 99-1.  Each hospital will be receiving only one user ID and that user ID will be assigned to the individual identified by the hospital as the one responsible for completing the reconciliation applications.

Steps to Complete the WEB BASED Reconciliation Application

You can access the WEB based reconciliation application only after you completed the HRSA Security Training

The first step is to complete the HRSA Security Training.  The training should take not more than 20 minutes. Based on the Computer Security Act of 1987, P.L. 100-235, and OMB Circular Number A-130, the CHGME Payment Program in coordination with the Office of Information Technology (OIT) in HRSA requires each person that uses a Federal system to take a security training document and sign a Rules of Behavior (ROB) document. You will register as a new user and create your own ID and password. Please keep your login and password since this training must be completed once a year to use a Federal system. The ROB document will be sent to you via email. The person who is responsible for completing the application (Line #6 of the HRSA 99) will be the person who is required to take the training. Please take this training as soon as possible once this alert is received.  The Office of Information and Technology also requires the “supervisor” to sign the ROB:  The person who signs the HRSA 99-3. When the training is complete, print the certificate and make sure the forms are signed. Please return a copy via fax to your regional manager.

Each hospital will receive one user ID. Once the HRSA security training is complete, the ROB is signed and certificate of completion of training is faxed to the database manager (Jill Schmid) at 301-443-1879, the user will receive an email with a USER ID and a TEMPORARY PASSWORD. The password must be changed the first time the user logs in.

Once the children’s hospital receives it user ID and create its password, it is ready to complete the reconciliation application.  The attachments with this alert provide you with instruction and guidance.

The CHGME Payment Program will be available to answer questions and help you through this new process.  If you are having difficulty, please contact your RM for help.   

FY 2008 Resident FTE Assessment Program

The CHGME Payment Program is drawing to a close its FY 2008 Resident Full-time Equivalent (FTE) Assessment Program.  Congratulations to all children's hospitals and their CHGME fiscal intermediaries (FIs) who continue to make this statutory requirement a success.

Children’s hospitals are reminded, that they should have in their possession a copy of their CHGME FI’s final Resident FTE Assessment Report.  The CHGME FIs included, as part of their final resident FTE assessment report for each hospital, a HRSA 99-1 which reflects the results of their findings.  These results must be used by the children’s hospitals to complete their FY 2008 reconciliation applications (see below).  Please also note that hospitals should follow-up with their Medicare and/or CHGME FI, as appropriate, to ensure that they have the most recent, up-to-date copies of their Medicare cost reports (MCRs), CMS 2552-96 Worksheet E-3, Part IVs and Part VI, for each applicable year identified in their FY 2008 CHGME Payment Program reconciliation application.  If an MCR is currently or was previously in a settled or resettled status, the CHGME PP expects the hospital to include with their FY 2008 CHGME Payment Program reconciliation application the “matching” Worksheet E-3, Part IVs and E-3, Part VI, where applicable, for each year identified. 

As a footnote, children's hospitals are also reminded that the Resident FTE Assessment Program is an ongoing process as children’s hospitals will continue to reflect data from more recently completed MCR periods in future CHGME Payment Program applications for funding.  For this reason, hospitals are strongly encouraged to continue their communications with their Medicare and CHGME FIs as they move forward and prepare for the FY 2009 CHGME Payment Program initial application cycle and the respective FY 2009 resident FTE assessment process.

FY 2008 Monthly Payments Based on the Reconciliation Application Cycle

Following the reconciliation application cycle, the CHGME Payment Program will recalculate payments based on changes reported by children’s hospitals in their reconciliation applications.  Following this process, notice of award letters will be sent to children’s hospitals identifying adjusted payment amounts.  Changes to monthly payments to reflect adjustments as a result of the Resident FTE Assessment Program and the processing of participating children’s hospitals reconciliation applications will begin in July 2008.

Related Policies and Regulations (to the FY 2009 CHGME Payment Program Initial Application Cycle)

Case Mix Index:  Children's hospitals requesting funding for the FY 2009 application cycle, must submit a case mix index (CMI) based on the discharges from the most recently filed MCR for hospitals that file full MCRs or the most recently completed MCR period for hospitals that file low or no-utilization MCRs, using CMS-DRG Version 24 with the appropriate CMS Version 24 weights reported to the ten-thousandth decimal place.

Academic Year 2008-2009 Medicare GME Affiliation Agreement (for an Aggregate Cap):

Hospitals planning to participate in a Medicare GME Affiliation Agreement for Academic Year 2008-2009 (July 1, 2008 – June 30, 2009) are reminded that July 1, 2008 is the filing deadline to submit completed, fully executed, signed Medicare GME Affiliation Agreements to your Medicare FI with a copy to the CMS. Questions regarding Medicare GME Affiliation Agreements should be directed to your Medicare FI.

As always, if additional information or assistance is needed, please contact your CHGME PP designated regional manager: