4811 COST REPORTING AND RECORD MAINTENANCE

4811.1 Each hospital shall submit an annual cost report to the Medicaid Program within one hundred fifty (150) days after the close of the hospital's cost reporting period. Each cost report shall cover a twelve (12) month cost reporting period, which shall be the same as the hospital's fiscal year, unless the Medicaid Program has approved an exception.

4811.2 Each hospital shall complete its cost report in accordance with Medicaid Program instructions and forms and shall include any supporting documentation required by the Medicaid Program. The Medicaid Program shall review the cost report for completeness, accuracy, compliance and reasonableness through a desk audit.

4811.3 The submission of an incomplete cost report shall be treated as a failure to file a cost report as required by subsection 4811.1, and the hospital shall be so notified.

4811.4 The Medicaid Program shall issue a delinquency notice to the hospital if the hospital does not submit its cost report on time or when the hospital is notified pursuant to subsection 4811.3, that its submitted cost report is incomplete.

4811.5 If the hospital does not submit a complete cost report within thirty (30) days after the date of the notice of delinquency, twenty percent (20%) of the hospital's regular monthly payment shall be withheld each month until the cost report is received. If a complete cost report is not filed within ninety (90) days of the notice of delinquency, one hundred percent (100%) of the hospital's regular monthly payment shall be withheld each month until a complete report is filed.

4811.6 The Medicaid Program shall pay the withheld funds promptly after receipt of the completed cost report and documentation that meets the requirements of this section.

4811.7 Each hospital shall maintain sufficient financial records and statistical data for proper determination of allowable costs.

4811.8 Each hospital's accounting and related records, including the general ledger and books of original entry, and all transaction documents and statistical data, are permanent records and shall be retained for a period of not less than five (5) years after the filing of a cost report or until the

Notice of Final Program Reimbursement is received, whichever is later.

4811.9 If the records relate to a cost reporting period under audit or appeal, records shall be retained until the audit or appeal is completed.

4811.10 Payments made to related organizations and the reason for each payment to related organizations shall be disclosed by the hospital.

4811.11 Each hospital shall:

(a) Use the accrual method of accounting; and

(b) Prepare the cost report according to generally accepted accounting principles and all Medicaid Program instructions.

SOURCE: Final Rulemaking published at 45 DCR 4141, 4150 (June 26, 1998); as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 2691 (March 26, 2010)[EXPIRED]; as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 6837 (July 10, 2010)[EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 4323, 4331 (May 20, 2011).