OMB control number

Supplemental to Form CMS-2552-10 Payment Adjustment for Establishing and Maintaining Access to Buffer Stock of Essential Medicines (CMS-10897)

OMB 0938-1473 · HHS/CMS.

OMB 0938-1473

The Supplemental to Form CMS-2552-10 cost report is needed to determine the payment adjustment for the additional resource costs of establishing and maintaining access to no less than a 6 month buffer stock of one or more essential medicines for cost reporting periods beginning on or after October 1, 2024. The payment adjustment is limited to 1886(d) hospitals that have 100 or fewer beds as defined in 42 CFR 412.105(b), and are not part of a chain organization (independent).

The latest form for Supplemental to Form CMS-2552-10 Payment Adjustment for Establishing and Maintaining Access to Buffer Stock of Essential Medicines (CMS-10897) expires 2027-11-30 and can be found here.