Medicare Reimbursable Bad Debts


*Part of the Healthcare Providers Reimbursement Series

As part of the annual Medicare cost report filing, hospitals, Critical Access Hospitals (CAHs) and other providers that file a Medicare Cost Report can claim unpaid Medicare patient deductibles and coinsurance as reimbursable bad debts. Reimbursement is made at 65% of the claimed dollar amount. Obtaining reimbursement on these unpaid copayment obligations requires strict compliance with Medicare regulations and Provider Reimbursement Manual Part I and Part II sub-regulatory guidance.

This course will cover regulatory and documentation requirements surrounding the allowability of the Medicare Bad Debts on the Medicare Cost Report, common provider errors that trigger disallowance during Medicare Administrative Audits, recent regulatory developments and new filing requirements required by Cost Report Transmittal 18, effective for cost reports starting on or after October 1, 2022.  Specific billing and collection policies and procedures providers must adopt, indigency determinations, use of third-party collection agencies, and Medicare/Medicaid dual eligible patient accounts and other requirements specific to claiming the Medicare Bad Debts on the annual cost report will also be covered.

In addition, recent provider appeal and litigation has been settled with CMS. We will discuss the litigation and impact upon reporting Medicare bad debts on future cost reports, including the process for making indigency determinations.


CPE Credit


2:00 pm – 3:00 pm 


Learning Objectives:

  • Understand the cost reporting documentation requirement for claiming Medicare Bad Debts on the cost report
  • Learn about minimal collection and billing requirements on Medicare bad debts accounts
  • Review indigency determinations that allow claiming Medicare Bad Debts without extensive collection activities

Who Should Attend:

  • CFOs
  • Hospital Personal responsible for the annual Medicare Cost Report
  • Revenue Cycle and Reimbursement Professionals
  • Controllers and Accountants


Ovation Healthcare
Vice President, Regulatory & Financial Reporting

In order to be awarded the full credits, you must respond to the three polling questions asked during the program and complete the evaluation.

Participants will earn 1.0 CPE credit

  • Field of Study: Specialized Knowledge
  • Prerequisites: None
  • Advanced Preparation: None
  • Program Level: Basic
  • Delivery Method: Group Internet Based


Ovation Healthcare Learning Institute (OLI) is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website:

OLI may cancel or reschedule a live webinar program at its discretion due to unforeseen circumstances. We will use reasonable efforts to notify registrants of the cancellation at least two weeks (10 business days) in advance of the original live webinar program.

If OLI cancels a live webinar program, refunds of the webinar registration fee will not be given. However, all current registrants at time of cancellation will obtain a credit to be applied to a future live webinar program of their choice.

Complaint Resolution:

For information regarding refunds, program cancellation policies and/or concerns please contact our client support team at 615-371-7979 or