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When to File - Deadlines, Timing Considerations, Risks & Benefits

The Volume Decrease Adjustment (VDA) is an important benefit to assist Medicare Dependent Hospitals (MDH) and Sole Community Hospitals (SCH) when they experience a decline in inpatient volume of greater than 5%. In order to receive the money, a written request must be submitted to the Medicare Administrative Contractor (MAC). The natural question many providers will have is, “when do we need to submit our request?”

There are two answers to this question. The first is that a VDA request must be submitted no later than 180 days after the date of the Notice of Program Reimbursement (NPR) for the year in question. Any request submitted after this date will be rejected by the MAC.

The second answer is that the VDA request should be submitted as soon as possible after filing the cost report. There are several reason s for this timing, including:

  1. Submitting after filing the cost report allows time to focus on preparing the cost report and ensuring the accuracy of all aspects. This also ensures that the potential VDA amount will be confirmed before preparing the request.
  2. Submitting after filing but prior to receipt of the NPR provides the MAC with the opportunity to review the VDA request at the same time they perform the audit of the cost report.
  3. If the request is approved prior to the NPR, payment can be made via a revised tentative settlement which does not require a reopening. This shortens the time between approval and receipt of the funds.
  4. The NPR process can, and has, taken two to three years from submission of the cost report to completion. Submitting the VDA request as soon as possible gets the money to the hospital sooner, allowing the funds to assist the hospital operations.

The Rybar Group has over 30 years of experience requesting VDAs, and we will work with your MAC to get the money to your facility as quickly as possible. Please contact Steve Sprague, ssprague@therybargroup.com or 810-853-6169, today to discuss your situation.

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