CMS Pub. 100-04, ch. 4, § 10.11.3.1

Effective January 1, 2009, the central office may direct Medicare contractors to use an

alternative CCR if CMS believes this will result in a more accurate CCR. Also, if the

Medicare contractor finds evidence that indicates that using data from the latest settled or

tentatively settled cost report would not result in the most accurate CCR, then the

Medicare contractor shall notify the CMS central office and CMS regional office to seek

approval to use a CCR-based on alternative data. For example, CCRs may be revised

more often if a change in a hospital or CMHC’s operations occurs which materially

affects a hospital or CMHC’s costs and charges. The central and regional offices must

approve the Medicare contractor’s request before the Medicare contractor may use a

CCR-based on alternative data. Revised CCRs are applied prospectively to all OPPS

claims processed after the update. Medicare contractors shall send notification to the

central office via the following address and e-mail address:

CMS

C/O Division of Outpatient Care - OPPS Outlier Team

7500 Security Blvd.

Mail Stop C4-05-17

Baltimore, MD 21244

outliersopps@cms.hhs.gov