Dear Hospital Provider,
Many Medicare-certified hospitals in Colorado have IPPS excluded-beds through psychiatric or rehabilitation units. If your facility has a 12/31 fiscal year end date the deadline to submit your documentation for the 2018 fiscal year is approaching. Attestation documentation is submitted annually for psychiatric units and once every three years for rehabilitation units.
The CMS Regional Office is also in the process in updating many of its records related to PPS exemption units. In your submissions for the coming fiscal year please include a PDF submission of blueprints for the IPPS unit or units. These blueprints will then be sent to CMS along with your documentation.
In addition to current blueprints the required documents are:
A completed CMS Form 437 (psychiatric unit) or CMS Form 437A (rehabilitation unit) - please see below for links to the documents.
A completed attestation statement on facility letterhead signed by the facility administrator and the unit director stating that the director works at least 20 hours a week and documentation verifying this. A link is provided below for a sample attestation form.
We would also strongly encourage you to submit your documentation as far in advance as possible to allow the state agency (CDPHE) to process and transmit the required documentation to the regional office prior to the last few business days of the fiscal year.
If you have any questions please contact Greg Wright at 303-692-2813 or greg.wright@state.co.us
Forms:
CMS Form 437 is available at: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS437.pdf
CMS Form 437A is available at: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS437A.pdf
Sample attestation form: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_127.pdf
For the same attestation form the name and address of the PPS contact at the Regional Office is:
Laura Trujilo, Health Insurance Specialist
CMS Region VIII
1961 Stout St., Room 08-148
Denver, CO 80294
This blog publishes information typically sent to users of the Colorado Health Facilities Interactive (COHFI) system for health care entities regulated by the Colorado Department of Public Health and Environment. Please note that COHFI is the official medium for business communication between the Department and licensed and/or Medicare/Medicaid certified health care entities. Health care entities should continue to monitor their email accounts routinely.
