The Volume Decrease Adjustment (VDA) is an important benefit to assist Medicare Dependent Hospitals (MDH) and Sole Community Hospitals (SCH) when they experience a decline in inpatient volume of greater than 5%. In order to receive the money, a written request must be submitted to the Medicare Administrative Contractor (MAC). After filing the request many Providers will wonder, “What’s next?”

There are regulatory and practical answers to this question. On the regulatory side the MAC has 180 days from when they receive “all required information.” All required information is determined by the MAC, and requests for additional information can reset the clock. This is why it is important to submit a detailed request, and respond quickly to any requests for additional information sent by the MAC.

The practical answer to this question is to not just sit back and wait for the MAC. Once the request is submitted it is important to confirm that the MAC received the request. This confirmation should be received quickly, typically within a day or two of submitting the request, but certainly no more than a week later.

After confirming the MAC has received the request, it is a good practice to check in periodically with the MAC to ensure that the review is on track, that no requests for additional information were missed, and to discuss an estimate of when the review will be complete.

RubinBrown can help manage all ongoing communications with your MAC related to the VDA request, ensuring your facility receives its payment as quickly as possible. To learn more, please contact your RubinBrown team. 

 

Published: 10/08/2024

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