CMS has engaged a third-party firm to conduct focused reviews of hospitals’ Medicare cost report Worksheet S-12 uncompensated care reporting, creating an additional layer of scrutiny beyond traditional Medicare Administrative Contractor (MAC) cost report reviews.
Affected hospitals will be required to provide supporting documentation within specified deadlines. The notice states that any adjustments will be incorporated into cost report settlements. It is essential for hospitals to have supporting documentation available that validates the accuracy of their Worksheet S-12 data and supporting records.
Hospitals should also note that the calendar year 2026 Outpatient Prospective Payment System final rule requires hospitals to encode the “median allowed amount” and related allowed-amount fields when a payor-specific negotiated charge (PSNC) is based on a percentage or algorithm. The rule separately requires S-12 reporting to use the Medicare Advantage Organization (MAO) PSNC information disclosed in the hospital’s most recent machine-readable file.
How Forvis Mazars Can Help
Our professionals have extensive experience supporting hospitals with cost reporting, price transparency compliance, revenue cycle/revenue integrity, and managed care contracting. If you have questions about the Worksheet S-12 reviews and how they may affect your organization, please reach out to our team today.