Rule 23-207-3.6 - ReimbursementA. Participating Mississippi intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) must prepare and submit a Long-term Care Medicaid cost report for reimbursement. 1. All cost reports are due by the end of the fifth (5th) calendar month following the reporting period.2. Failure to file a cost report by the due date or the extended due date will result in a penalty of fifty dollars ($50.00) per day and may result in the termination of the provider agreement.B. The Division of Medicaid uses a prospective method of reimbursement. 1. The rates are calculated from cost report data.2. The rates are calculated annually with an effective date of January first (1st).3. In no case may the reimbursement rate for services provided exceed an individual ICF/IID's customary charges to the general public for such services in the aggregate, except for those public facilities rendering such services free of charge or at a nominal charge.4. Prospective rates may be adjusted by the Division of Medicaid pursuant to changes in federal and/or state laws or regulations.5. Prospective rates may be adjusted by the Division of Medicaid based on revisions to allowable costs or to correct errors. a These revisions may result from amended cost reports, audits, or other corrections.b Facilities are notified in writing of amounts due to or from the Division of Medicaid as a result of these adjustments.c There is no time limit for requesting settlement of these amounts. This is applicable to claims for dates of service since July 1, 1993.C. The Division of Medicaid conducts periodic cost report financial reviews of selected ICF/IIDs to verify the accuracy and reasonableness of the financial and statistical information contained in the Medicaid cost reports. Adjustments will be made as necessary to the reviewed cost reports based on the results of the reviews.D. Notwithstanding any other provision of this article, it shall be the duty of each ICF/IID that is participating in the Medicaid program to keep and maintain books, documents and other records as prescribed by the Division of Medicaid in substantiation of its cost reports for a period of three (3) years after the date of submission to the Division of Medicaid of an original cost report, or three (3) years after the date of submission to the Division of Medicaid of an amended cost report. 1. Providers must maintain adequate documentation including, but not limited to, financial records and statistical data, for proper determination of costs payable under the Medicaid program. a The cost report must be based on the documentation maintained by the ICF/IID.b All non-governmental ICF/IIDs must file cost reports based on the accrual method of accounting.c Governmental ICF/IIDs have the option to use the cash basis of accounting for reporting.2. Documentation of financial and statistical data should be maintained in a consistent manner from one period to another and must be current, accurate and in sufficient detail to support costs contained in the cost report.3. Providers must make available to the Division of Medicaid all documentation that substantiates the information included in the ICF/IID cost report for the purpose of determining compliance. a These records must be made available as requested by the Division of Medicaid.b All documentation which substantiates the information included in the cost report, including any documentation relating to home office and/or management company costs, must be made available to Division of Medicaid reviewers as requested by the Division.23 Miss. Code. R. 207-3.6
42 C.F.R. § 447, Subparts B and C; Miss. Code Ann. §§ 43-13-117, 43-13-121.