General Reporting Instructions - (Rev. 5, 08-30-02)

90.5 - General Reporting Instructions - (Rev. 5, 08-30-02) A1-1414.5 Where money is withheld from payments due the provider (as an offset) for monies due the contractor, the contractor shall show the gross amount (less any deductibles, coinsurance, interest, or sequestration) as the payment on the appropriate line and column. It shall show the offset as a negative amount in its appropriate line and column. For example, when the contractor reduces a PPS Periodic Interim Payment (PIP) for a settlement amount due from the provider, it shall record the gross PIP amount (less any deductibles, coinsurance, interest, or sequestration) on line lA in column 1 (a) or 1(b), as appropriate. It shall record the offset on line 6B in column 1(a) or 1(b), as appropriate. However, it shall record a claim adjustment (e.g., a PRO disallowance or subsequent reversal) as a reduction of claims payments on line 2A for a non-PIP/PPS hospital. Where the contractor makes an accelerated payment and the provider repays a portion of the accelerated payment during the same reporting period, the contractor shall show the net amount on the appropriate line and column. For example, when an accelerated payment of $100,000 is made to a provider during the period, and the provider repays $30,000 during the same period, the contractor shows $70,000 as the net accelerated payment. In situations where an accelerated payment is made during the period, and the contractor recovers a portion of the accelerated payment through reduction of interim payments, it shall show the gross amount (less any deductibles, coinsurance, interest, or sequestration) of interim payments as payment on the appropriate line and column. It shall show the offset amount as a negative amount on the appropriate line and column. For example, when an accelerated payment is made for $100,000 and later in the month $30,000 of the accelerated payment is recouped by offset against PPS/PIP amounts of $150,000 paid to the provider, the contractor shows the $150,000 gross PPS/ PIP amount on line 1A in column 1(a) or 1(b), as appropriate. It shows a net accelerated payment of $70,000 ($100,000-$30,000) on line 7 in column 1(a) or 1(b), as appropriate.