RSM Resources

Due to continuous changes in the regulatory environment, many health care organizations are struggling to keep up and as a result, are putting themselves at risk for financial and regulatory instability.

Since regulatory matters arecomplex and require specialized skills and an in-depth understanding ofMedicare statutes, outside assistance is often needed to ensure compliance andidentify reimbursement opportunities.

How we can help
At RSM McGladrey, our healthcare consultants have extensive experience covering the regulatory, operationaland financial aspects of the changing health care environment. Because weunderstand the federal, state and local financial requirements governing healthcare organizations, we not only help you comply with these requirements, butalso provide recommendations to improve your operations.

We provide a comprehensiverange of regulatory services, including:

• Regulatory reporting
• Regulatory recovery
• Reopenings and appeals
• Prospective payment system(PPS) and critical access hospital (CAH) consulting
• DSH reimbursement and SSIeligibility
• Medicare bad debts
• Wage index reviews

Our regulatory reportingservices are designed to help you reach compliance with cost reportingregulations and optimize reimbursement opportunities. Our approach oftenincludes:

• Preparing a cost reportpreparation work plan, including appropriate timing for completion of specificsections of the Medicare, Medicaid and Blue Cross cost reports
• Summarizing financial andstatistical information to complete a detailed workpaper package in support ofthe submitted cost report
• Completing all cost reportschedules and attachments required by the intermediary to ensure a completecost report package is submitted on a timely basis
• Facilitating a discussionwith hospital personnel to ensure a complete understanding of all complexreimbursement issues
• Reviewing potentialreimbursement issues with cost report staff to address potential opportunitiesto enhance reimbursement

Because our health carepractice is highly focused on Medicare and Medicaid regulatory services, wehave significant experience interpreting and applying related statutes,regulations, instructions and other regulatory guidance.