Ohio Medicaid Hospital Cost Report

JFS Paid Claims Data Usage

The Ohio Medicaid Hospital Cost Report (JFS 02930) is used to report the Cost and Charges for the Title XIX and Title V Programs. It is also used to report the Uncompensated Care Data for the Hospital Care Assurance Program (HCAP), formerly reported on ODHS 2929.

• Automated Cost Report User's Manual
• Ohio Medicaid Hospital Cost Report Instructions - Updated for the SFY 2013 Cost Report
• Cost Report Crosswalk - CMS 2552-10 - JFS 02930
• Ohio Medicaid Hospital Cost Report Software - The contents of the file will be copied to C:\Hospital Cost Report on your computer. Please review the Instructions and User's Manual prior to completing the cost report. These files are also included in the download file.
• Cost Report Submission Checklist
• Patient Log Templates - These are provide for use as tool to compile the necessary data to complete Schedules F, I & J of the cost report. Please see the Cover tab of the file for more information.
• SFY 2012 Cost Report Instructions - These instructions have been updated to be in compliance with the expectations of the Federal DSH Audit.  

The department has granted an extension (see cost report instructions) to filers whose cost report would normally be due on June 30, 2012. It would be preferred that hospitals take this opportunity to complete/compile any additional information and to refrain from requesting additional time to complete the cost report filing.

Completion of OBRA survey required: Providers are required to complete both sections A and B of the OBRA Survey. Failure to complete the survey, constitutes an incomplete report and shall be subject to the $1,000/day fine.