ABCs of the Medical Care Surcharge Calculation

1
ABCs of the Medical Care Surcharge Calculation

• Prepared by the Minnesota Department of Health
  (MDH)
• Distributed with Permission from the Department
  of Human Services (DHS)

2
Uses of HCCIS Data

• Providing estimates of health care spending and
  aggregate hospital utilization in the state
• Monitoring the impact of health care reform and
  cost containment strategies  
• Calculating and implementing the hospital Medical
  Care Surcharge  
• Determining eligibility and awards for
• Sole Community Hospital Grants
• Rural Hospital Transition Grants
• Rural Hospital Consolidation Demonstration
  Program
• Rural Hospital Capital Improvement Program 
• Identifying Critical Access hospitals for
  participation in the Medicare Rural Hospital
  Flexibility Program

3
Calculation Used with 2001 Data

• A 0740 - (5501706170687075) 0841
  (5502706270697076)
• 0842 (5506706370707077)
• B 0760 (5503706470717078)
• 0741 (5504706570727079)
• 0742 (5507706670737080)
• C 0621 - (5505706770747081)
• D (A B) C
• Surcharge Amount D x .0156

4

• Minnesota Rules Chapter 4650 were amended in
  November 2001 and define
• Hospital Patient Care Services
• Other Patient Care Services Provided by the
  Hospital
• Additional codes are required starting with 2001
  Hospital Annual Report (HAR)

5
New Codes Added
6
Total Charges
7
Medicare Charges
8
Medicare Managed Care Charges
9
Total Adjustments
10
Medicare Adjustments
11
Medicare Managed Care Adjustments
12
Bad Debt
13
Use of New Codes with 2002 Data
14
Net Hospital Patient Care Charges
15
Net Hospital Patient Care Adjustments
16
Bad Debt
17
Surcharge Base
18
Surcharge Amount
19
Calculation Used with 2002 Data

• A 7090 - (71047106)
• B 7125 - (70987100)
• C 7083
• D (A B) C
• Surcharge Amount D x .0156

20
Resources to Contact

• Uses of HCCIS data
• Amy Camp, HCCIS Administrator MDH 651-282-3818,
  amy.camp_at_health.state.mn.us
• HCCIS web site www.health.state.mn.us/divs/hpsc/da
  p/hccis
• Medical Care Surcharge
• Tammy Baker, Special Recovery Unit - DHS
  651-297-8235, tammy.baker_at_state.mn.us