SA Reverification of PPS-Excluded Hospitals and Units

3110 - SA Reverification of PPS-Excluded Hospitals and Units (Rev. 1, 05-21-04) 3110A - Annual Reverification Process for Nonaccredited, PPS- Excluded, Rehabilitation Hospitals and Units (Rev. 1, 05-21-04) • 120 days before the beginning of the next cost reporting period, the SA notifies the excluded hospital or unit (Exhibit 126) that it must self-attest to compliance with the appropriate requirements in 42 CFR 412.23(b), 412.25, and/or 412.29. • The SA includes a copy of the attestation statement (Exhibit 127) and the appropriate hospital or unit criteria worksheet (Form CMS-437A or 437B, Exhibit 73); • The hospital/unit is to return the completed/signed worksheet and signed attestation statement to the SA office no later than 90 days before the beginning of its next cost reporting period; • The SA transmits the completed attestation statement and worksheet, along with its recommendation for reverification, to the RO at least 60 days prior to the end of the hospital’s cost reporting period for inclusion with other information necessary for determining exclusion from PPS. 3110B - Reverification Process for Rehabilitation Hospitals and/or Units Accredited by CARF Under CIRP or JCAHO (Rev. 1, 05-21-04) Accredited rehabilitation hospitals or units may be presumed to meet the criteria in §§3104.B or 3106.C, excluding the 75 percent rule (verified by the intermediary and the director requirement (42 CFR 412.23(b)(5) or 412.29(f)(1), as appropriate). Accredited rehabilitation hospitals/units self-attest to compliance with the director requirement on Form CMS-437A or Form CMS-437B using the same procedure and processing timeframes as used for nonaccredited hospitals/units. 3110C - Reverification Process for Psychiatric Units of Hospitals: (Rev. 1, 05-21-04) • The SA uses the same process and timeframes as those used for nonaccredited rehabilitation hospitals and units to determine if the unit meets the specific criteria for psychiatric units in §3106; and • The SA provides the psychiatric unit with the criteria worksheet for psychiatric units, Form CMS-437 (Exhibit 73), along with Exhibit 126 and the attestation statement (Exhibit 127). Hospitals/units that do not self-attest to meeting all exclusion criteria at the time of the annual self-attestation may still be eligible for exclusion. They must provide strong verifiable evidence documenting compliance with exclusion requirements at least 15 days prior to the beginning of the cost reporting period. If necessary, the SA contacts the hospital/unit again to confirm compliance. A SA onsite visit generally is not required to confirm evidence submitted subsequent to self-attestation.