Home Office Cost Statements

A home office of a chain organization is a related organization to its participating providers. Home offices usually furnish central management and administrative services, e.g., centralized accounting, purchasing, personnel services, management direction and control and other services. To the extent that the home office furnishes services related to patient care to a provider, the reasonable costs of such services are included in the provider’s cost report and are reimbursable as part of the provider’s costs.

Effective for cost reporting periods beginning on or after 10/1/2018, for providers claiming costs on their cost report that are allocated from a home office or chain organization with the same fiscal year end, a cost report will be rejected for lack of supporting documentation if the home office or chain organization has not completed and submitted to the chain provider’s contractor a Home Office Cost Statement that corresponds to the amounts allocated from the home office or chain organization to the provider’s cost report. Conversely, for providers claiming costs on their cost report that are allocated from a home office or chain organization that has a different fiscal year end, a cost report will be rejected for lack of supporting documentation if the home office or chain organization has not submitted to the chain provider’s servicing contractor, a Home Office Cost Statement that corresponds to some portion of the amounts allocated from the home office or chain organization to the provider’s cost report.

The Home Office Cost Statement CMS Form 287-22 now supports e-signature. When filing via MCReF, there is no longer a requirement to upload a scanned copy of the certification page via the “Signed Certification Page” slot and mail a hard copy with a signature signed in ink to your MAC. Refer to the Submit Supporting Documentation section of our website for more details.

If claiming home office costs, a provider must ensure they are submitting an acceptable Home Office Cost Statement to the home office’s MAC. Also, the home office must send one copy of the Home Office Cost Statement to each of the MACs for the chain providers.

For example, if a chain organization has 25 providers serviced by two different contractors, the home office must submit one copy of its Home Office Cost Statement to each of the two contractors.
For the other contractors which are not the home office’s MAC, indicate that the home office cost statement being provided is a duplicate/informational copy to avoid confusion that it may be an actual cost statement submission.

If there is no home office number set up and you will be claiming home office costs, contact the applicable MAC to get one established. The MAC for the home office will be based on the physical location of the home office. Refer to the MAC listing on the CMS website.

If the MAC for the home office will be NGS, you should complete the Home Office Request Form and send it to jk_cost_report_filing@anthem.com for JK or j6_cost_report_filing@anthem.com for J6. Note there are two tabs in the spreadsheet.

Home office costs allocated to regional offices are subsequently allocated to the regional components on separate regional office home office cost statements. If a regional home office situation is applicable, separate home office cost statements may be required. CMS approval for each separate regional home office is required.

Home Office Cost Statements

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