The Centers for Medicare and Medicaid Services (CMS) issued Change Requests 1369 and 2692 to implement §541 of the Balanced Budget Refinement Act (BBRA) of 1999 and §512 of the Benefits Improvement and Protection Act (BIPA) of 2000 regarding Managed Care nursing and allied health payments are effective for portions of cost reporting periods occurring on or after January 1, 2000.

These two regulations provide for additional payments to hospitals for costs of nursing and allied health education associated with services to Managed Care enrollees. Hospitals that operate approved nursing or allied health education programs and receive Medicare reasonable cost reimbursement for these programs would receive additional payments. The additional payment is reported on Worksheet E Part A of the Medicare cost report (Worksheet E-3 Part I for freestanding non-IPPS facilities). The regulations also provide that direct Graduate Medical Education (GME) payments for Managed Care utilization will be reduced to the extent that these additional payments are made for nursing and allied health education programs. This reduction is performed on Worksheet E-3 Part IV of the Medicare cost report.

Empire Medicare Services has developed a document to assist providers in calculating the Nursing and Allied Health Managed Care payment.

NAH_Cal.xls