Cost Reporting and Review
Hospice Financial Reporting
All reports/documents must be submitted as email attachments to the Department's Cost Reporting Program: email@example.com.
Required reporting is comprised of the following:
- Uniform Accounting Report (UAR) which includes:
- Arizona Hospice state UAR form (available below)
- Medicare Cost Report (MCR) copy
- Statement of Cash Flow
- Attestation of Completeness and Accuracy (available below)
- Uniform Accounting Report (UAR)
The UAR is due 150 days after the hospice’s fiscal year end. There Are No Filing Extensions For Reporting Of Uar/mcr. The completed UAR form, Medicare Cost Report copy in PDF format and Attestation of Completeness and Accuracy must be submitted together.
- Uniform Accounting Report: HSPC-9999_CCYYMM_FYCCYY_UAR
- Uniform Accounting Report - Supplemental: HSPC-9999_CCYYMM_FYCCYY_UAR-SUPP
- Medicare Cost Report: HSPC-9999_CCYYMM_FYCCYY_MCR
- UAR Attestation: HSPC-9999_CCYYMM_FYCCYY_ATT-UAR
- HSPC-9999 = your facility license number; i.e. HSPC-1234
- CCYYMM = the year/month you are reporting to the Department; i.e. 201504
- FYCCYY = the facility fiscal year of this reporting; i.e. FY2014
The requirements for this reporting are found in Arizona Administrative Code, Title 9, Chapter 11, available on the Arizona Secretary of State's web site.