Financial Statements & Accounting Data

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10 Νοε 2013 (πριν από 3 χρόνια και 11 μήνες)

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Health Budgets &
Financial Policy

Financial Statements &
Accounting Data


TMA Office of the Chief Financial Officer (OCFO)

Management Control & Financial Studies Division


Health Budgets &
Financial Policy

2

Outline



Financial Statement Reporting Requirement


Legacy Accounting Systems


Medical Accounts Receivable (A/R)


Managed Care Forecasting & Analysis System
(MCFAS)


Health Budgets &
Financial Policy

3


CFO Act of 1990: Integrated Financial Management
(FM) systems supporting DoD accounting needs are key
to effective financial management


Federal Financial Management Improvement Act
(FFMIA) of 1996:
All

Federal agencies to comply


Implement/maintain systems that meet Federal FM
system requirements (Joint Financial Management
Improvement Program (JFMIP))


Support Federal accounting standards (Federal
Accounting Standards Advisory Board (FASAB))


Apply US Standard General Ledger (USSGL) at the
transaction level


Fiscal Management Requirements


Health Budgets &
Financial Policy

4

Financial Statements

MHS Financial Statement Reporting
Entities (FSREs)


MHS

MERHCF
1

DHP
3

TRICARE Mgmt.

Activity (TMA)

Service Medical

Activity (SMA)

TMA
-

FOD

TMA


CRM
1


TMA
-
USUHS
2

SMA


Army

(MEDCOM)
4


(USACE)
5


SMA


Navy

(
BUMED
)
4


(NAVFAC)
5


SMA


Air Force

(AFMS)
4


(USAFE)
5


(1
) Under Audit

(2) All Proprietary Statements Validation
Through Examination In Process

(3) Includes American Recovery and


Reinvestment Act (ARRA) Funding

(4) Executes DHP Funds

(5) Executes MILCON Funds

MERHCF: Medicare
-
Eligible Retiree Health
Care Fund

DHP: Defense Health Program Appropriation

MILCON: Military Construction Appropriation

FOD: Financial Operations Division

CRM: Contract Resource Management

USUHS: Uniformed Services University

MEDCOM: Army Medical Command

BUMED: Navy Bureau of Medicine and Surgery

AFMS: Air Force Medical Service

USACE: U.S. Army Corps of Engineers

NAVFAC: Naval Facilities Engineering
Command

USAFE: U.S. Air Forces in Europe

MILCON
3


Health Budgets &
Financial Policy

5




Accounting Data

FSRE

Legacy

Enterprise

Business
Rules

Command
Control

TMA

WAAS

DAI

TMA

TMA

USUHS

CUFS

DAI

USUHS

USUHS

Army

STANFINS

GFEBS

Army

Army

Navy

STARS
-
FL

Navy ERP

Navy

Navy

Air Force

GAFS
-
R

DEAMS

Air Force

Air Force


Health Budgets &
Financial Policy

6

Accounting System Acronyms



CUFS



College and University Financial System

DAI



Defense Agency Initiative

DEAMS



Defense Enterprise Accounting and Management System

FSRE



Financial Statement Reporting Entities

GAFS
-
R



General Accounting Financial System
-

Revised

GFEBS



General Fund Enterprise Business System

STANFINS



Standard Army Finance Information System

STARS
-
FL



Standard Accounting and Reporting System
-

Field Level

TMA



TRICARE Management Activity

USUHS



Uniformed Services University of the Health Sciences

WAAS



Washington Headquarters Services (WHS) Allotment
Accounting System


Health Budgets &
Financial Policy

7


Office of Management & Budget (OMB)


Use commercial off
-
the
-
shelf (COTS) JFMIP
-
certified software for replacement of core FM
systems (OMB Circular A
-
127)


New Service FM COTS are JFMIP
-
certified


Army


General Fund Enterprise Business System
(GFEBS)


SAP COTS


Navy


Navy Enterprise Resource Planning (ERP)


Oracle COTS


Air Force


Defense Enterprise Accounting and
Management System (DEAMS)


Oracle COTS


Fiscal Management Requirements


Health Budgets &
Financial Policy

8


Standard Financial Information Structure (SFIS)


A comprehensive, standard “business language”
that defines financial information that supports all
DoD
-
wide budget, cost/performance management,
and external reporting requirements


SFIS is
NOT

an IT system


http://www.defenselink.mil/dbt/sfis_resources.html

What is SFIS?


Health Budgets &
Financial Policy

9

Financial Statements


FSRE Structure Challenges


TMA

clear chain of command and
organizational structure


MERHCF

actuarial and accounting information


SMA

components have two lines of authority
(command and control, and finance business
rules) vs dollar flow. Face issues related to
MILDEP priorities vs fund flow priorities:
financial impact, accounting system, financial
business rules


Health Budgets &
Financial Policy

10

Financial Statements


FSRE Structure Challenges (continued)


Solution: single accounting system with
common business rules and chain of command
simplifies, streamlines the financial statement,
financial reporting, financial performance
reporting


Health Budgets &
Financial Policy

11

Financial Metrics


Monthly Reporting, History and Measures


Accounts Receivable (A/R) Public debt > 30 days at
Sep 30, 2009 (Red Metric)


SMA
-
Army ($22.5 million)


A/R Intragovernmental Debt > 30 days at

Sep 30, 2009 (Red Metric)


SMA
-
Army ($17.7 million)


SMA Navy ($17.3 million)


SMA A/R increased dramatically in 1
st

Qtr FY 2010 when
recording begins





Health Budgets &
Financial Policy

12

Financial Metrics



Obligation Rates (9/30/2009) (Millions)


Procurement Fundings (3 year life)


FY 2009

FY 2008

FY 2007

SMA

$ 95.2
(57.6%)

$197.5
(78.5%)

$307.7
(99.9%)

TMA

$ 78.9
(40.2%)

$125.8
(58.6%)

$199.8
(100.0%)


Health Budgets &
Financial Policy

13

Financial Metrics


Research, Development, Test and Evaluation
(RDT&E) Fundings (2 year life)


FY 2009

FY 2008

SMA

$130.4
(14.0%)

$735.8
(99.9%)

TMA

$ 78.8
(42.5%)

$250.7
(99.7%)


Health Budgets &
Financial Policy

14


DoD Financial Management Regulation
(FMR), Volume 4, Chapter 3, “Receivables”
dated November 2009


DoD Financial Management Regulation
(FMR), Volume 6B, Chapter 10, “Notes to
Financial Statements” dated September 2008


Located at OSD (Comptroller) Web site:


http://www.defenselink.mil/comptroller/fmr/


DoD References


Health Budgets &
Financial Policy

15


Two types of A/R in governmental accounting


Intra
-
governmental

(e.g., Coast Guard, VA)


Expect to get paid 100% of Billed Amount


Disputes regarding claims against other federal
agencies (e.g., Coast Guard, VA) are to be
resolved per Code of Federal Regulations
4 CFR 101


Public

(civilian emergencies, TPC)


Need to establish an allowance for bad debt


MTFs may be reporting collections to higher
headquarters but what data is reported regarding
outstanding and aged (e.g., >30 days, >120 days)
Medical A/R?


Accounts Receivable (A/R)


Health Budgets &
Financial Policy

16

Third Party Collections


Total Third Party Collections (TPC) Billings were
in FY 2009 were $496.0 million


Total TPC Collections in FY 2009 were
$240.7 million


How much is really being written off as
uncollectible, and how much is still on the books
as Medical A/R?


Health Budgets &
Financial Policy

17

Medical Services Account (MSA)




Combination of both Intra
-
governmental A/R
(e.g., Coast Guard, VA) and Public A/R (e.g.,
civilian emergencies)


Total MSA amount collected TMA
-
wide in FY
2009 was $151 million


Health Budgets &
Financial Policy

18

Medical Affirmative Claims (MAC)


Medical Affirmative Claims (MAC) A/R is all
Public A/R (e.g., insurance companies, liable
individuals)


Total amount collected for medical care provided
in MTFs for FY 2009 was $15 million


Health Budgets &
Financial Policy

19


FMR guidance states:


The accounting office shall establish an
allowance for

doubtful debt
, which shall
provide for reducing gross receivables by the
amount of the estimated loss to their net
realizable value


A write
-
off occurs when an agency official
determines, after using all appropriate
collection tools, that is it
more than 50% likely

that a debt is uncollectible

Doubtful Accounts & Write
-
offs


Health Budgets &
Financial Policy

20


A/R are reported on the annual audited financial
statements


Service Financial Statements located at
OSD(Comptroller) Web site:


http://www.dod.mil/comptroller/cfs/fy2009.html

Service Financial Statements


Health Budgets &
Financial Policy

21

Accounts Receivable
-

Policy


Accounts Receivable Policy Memorandum (with
attachment)


Policy signed on May 8, 2008


Purpose


Establish policy for the recognition (“as rendered”),
classification, recording, aging, collection, disposition
and reporting of accounts receivable in order to improve
the accuracy of financial statements


Compliance with DoD’s Financial Management
Regulation (FMR) and Generally Accepted Accounting
Principles (GAAP)


Health Budgets &
Financial Policy

22

Accounts Receivable


Policy (con’t)


Implementation Date


1 October 2009 (for FY 2010 reporting purposes)


Title 10 United States Code, Chapter 55, Section 1095


This policy does
not

modify the ability of the Services to
use monies collected in the fiscal year collected

10 U.S.C. 1095(g) reads as follows: "Amounts collected
under this section from a third
-
party payer or under any
other provision of law from any other payer for health
care services provided at or through a facility of the
uniformed services shall be credited to the appropriation
supporting the maintenance and operation of the facility
and shall not be taken into consideration in establishing
the operating budget of the facility."




Health Budgets &
Financial Policy

23

Financial Metrics


Implementation of Medical A/R Policy in 1
st

Quarter of FY 2010 had a large impact


Accounts Receivable (A/R) Public debt > 30
days at Dec 31, 2009 (Red Metric)


SMA
-
Army ($358.7 million)


SMA
-
Navy ($5.8 million)


SMA
-
Air Force ($182.1 million)


Total reported Medical A/R was $546.6 million





Health Budgets &
Financial Policy

24

Management of Accounts Receivable


Revenue Recognition


All Defense Health Program (DHP) funded activities will
recognize and record a receivable when it establishes a
claim based on goods or services provided (“as
rendered”)


Financial statements have two A/R classifications:


Intragovernmental and Nonfederal (public)



Debt Management (Debt Collection Improvement Act
(DCIA)


Working with OUSD(C) to potentially add language to the
FMR to better clarify medical debt and when to “turn
-
it
over” to DFAS



Health Budgets &
Financial Policy

25

Management of Accounts Receivable
(continued)


Proprietary vs. Budgetary


Recommended accounting entries are:

Debit USSGL 1310 (Accounts Receivable) and credit
USSGL 6790 (Other Expenses Not Requiring
Budgetary Resources)


This will ensure a correct financial statement entry
without the potential for a appropriation violation and
maintain USC 1095 flexibility




Health Budgets &
Financial Policy

26

Accounts Receivable
-

Revenue
Recognition


All Defense Health Program (DHP) funded
activities will recognize and record a
receivable when it establishes a claim based
on goods or services provided (“as rendered”)



There are two classifications of accounts
receivables:



Intragovernmental


Nonfederal



Health Budgets &
Financial Policy

27

Accounts Receivable
-

Going Forward


Accuracy in reporting


Accounts receivable reports will be better than what we have
now


Reports will include aging data


Visibility of all accounts (including TPC accounts receivable
older than prior year 2)



Will become more accurate as procedures, systems and
data collection become more standardized



Central reporting will improve as funded systems change
request have been submitted to:


“Push” accounts receivable data from TPOCS and
CHCS/AHLTA (both MSA and inpatient TPC), and


Calculate interest in both MSA and TPOCS


Health Budgets &
Financial Policy

28

Accounts Receivable
-

Going Forward




Do not want to impact ability for billing
contractors to develop and/or use their own
billing management system


Possibility of accounts marked as transferred in
MSA, but documentation never forwarded to the
Defense Finance and Accounting Services
(DFAS) Support Center


Some joint ventures are generating Department
of Veterans Affairs bills on Excel spread sheets




Health Budgets &
Financial Policy

29

Accounting System


Going Forward


SMA Audit Committee will work with the SMA


Army, SMA


Navy, and SMA


Air Force to
establish procedures for recording AR


Provide your UBO Service Manager and Service
RM monthly AR data in the following categories:


Intragovernmental


MSA, TPOCS, Unbilled, changes to Allowance


Nonfederal


MSA, TPOCS, Unbilled, changes to Allowance


Health Budgets &
Financial Policy

30

Accounts Receivable

Service Points of Contact


Army
-



Navy
-



Air Force








Health Budgets &
Financial Policy

31

Managed Care Forecasting and Analysis System
(MCFAS)


End of year forecast by beneficiary group


Active duty (AD) and AD family members
using Service
-
supplied units


Retiree (R) or R family members or survivors
using actuarial model with inputs from
Defense Enrollment Eligibility Reporting
System (DEERS), new retirees and death
rates from DoD actuary, migration estimates


Mobilized Guard and Reserve (GR) and
Inactive GR

MCFAS


Health Budgets &
Financial Policy

32


Beneficiary demographics forecasted from
historical DEERS data


Use historical unit age/gender mix to
estimated demographics of Service
-
supplied
officer/enlisted unit endstrengths


Forecast ZIP Code location of beneficiaries


Map eligibles and historical enrollees to
geographic concepts


Drive
-
time market areas, catchment areas,
TRICARE Regions, MAJCOMs

MCFAS
(Continued)


Health Budgets &
Financial Policy

33

Active Duty/Family Members

Retirees/Family Members/Survivors

Active/Inactive Guard Reserve/Family Members

Comptroller


Active Duty FYDP

Office of DoD Actuary


Retiree Death Rates


Survivor Death Rates


New Retirees


Historical DEERS


Family Profiles


Student Losses


Migration Rates

Service Ops Plans


HA/TMA /Policy


Mobilization Assumptions


Forecasts of TRICARE Reserve Select


Timing/Duration of Transitional Benefits


DEERS


Eligible/Enrollee demographics

Market Areas


Drive
-
time Market Areas


TMA Catchment Area ZIP Codes

Geography


TMA DMIS ID table


MTF changes (e.g., BRAC)


Boundaries
-

Region, State,
Country, County, ZIP Code

MCFAS: Inputs


Health Budgets &
Financial Policy

34

Outline



Financial Statement Reporting Requirement


Legacy Accounting Systems


Medical Accounts Receivable (A/R)


Managed Care Forecasting & Analysis System
(MCFAS)


Health Budgets &
Financial Policy

35

Questions?




TMA OCFO/MC&FS