D.C. Mun. Regs. tit. 29, r. 29-4511
Current through Register 71, No. 45, November 7, 2024
Rule 29-4511 - EXCLUSIONS FROM ALLOWABLE COSTS4511.1 The costs that shall be excluded from allowable costs for purposes of calculating the APM rate shall include, but not be limited to, the following:
(a) Cost of services that are outside the scope of services covered under Section 1905(a)(2) of the Social Security Act and described in Sections 4505 - 4508;(b) Graduate Medical Education costs; and(c) Expenses incurred by the FQHC that are unrelated to the delivery of primary care, behavioral health and dental services as defined in Sections 4505 - 4508, which shall include but are not limited to the following:(1) Staff educational costs, including student loan reimbursements, except for training and staff development, required to enhance job performance;(2) Marketing and public relations expenses;(3) Community services that are provided as part of a large scale effort, such as a mass scale community wide immunization program or any other community wide service(4) Environmental activities;(6) Transportation costs except as provided for in Section 4510;(7) Indirect costs allocated to unallowable direct health service costs;(8) Entertainment including costs for office parties and other social functions, retirement gifts, meals, and lodging;(9) Board of Director fees;(10) Federal, state and local income taxes;(12) All costs related to physicians and other professional's private practices;(13) Donations, services and goods and space, except for those that are allowable pursuant to the Office of Management and Budget Circular No. A-122 and the Medicare Provider Reimbursement Manual;(14) Fines and penalties;(15) Bad debts, including losses arising from uncollectible accounts receivable and other claims, related collection and legal costs;(16) Advertising, except for recruitment of personnel, procurement of goods and services, and disposal of medical equipment and supplies;(17) Contributions to a contingency reserve or any similar provision made for an event, the occurrence of which cannot be foretold with certainty as to time, intensity, or with an assurance of the event taking place;(18) Over- funding of contributions to self- insurance funds that do not represent payments based on current liabilities;(19) Fundraising expenses;(21) Political contributions, lobbying expenses or other related expenses;(22) Costs attributable to the use of a vehicle or other company equipment for personal use;(23) Other personal expenses not related to patient care for the core services; and(24) Charitable contributions.4511.2 Costs reimbursed or otherwise paid for by locally funded grants or other locally funded sources, shall be offset against expenses in determining allowable cost. Such offset does not apply to local grants funded with federal dollars.
4511.3 An FQHC shall identify each grant by name and funding source in the supplemental data submitted with the cost report.
4511.4 Revenues related to the following categories shall be offset against expense.
(a) Investment Income: Investment income on restricted and unrestricted funds which are commingled with other funds must be applied together against, but should not exceed, the total interest expense included in allowable costs;(b) Refunds and rebates for expenses;(c) Rental income for building and office space;(d) Related organization transactions pursuant to 42 CFR § 413.17;(e) Sale of drugs to other than patient; and4511.5 Enabling services described in Subsection 4510.2 shall not include any services that may be or are included as a part of a patient encounter, administrative, facility or other reimbursable cost described in these rules. The costs of enabling services shall be reasonable as determined in accordance with the Medicare reasonable cost principles set forth in 42 CFR § 413.
D.C. Mun. Regs. tit. 29, r. 29-4511
Final Rulemaking published at 64 DCR 907 (2/2/2018)