Wage Index - What use to be so simple is now a very confusing web of regulations, calculations and documentation that significantly impacts Medicare reimbursement for most providers. Over 1/3 of hospitals in the country now qualify for some type of exception or special treatment. Additionally, there are adjustments to the wage index adjustment. The occupational mix adjustment is one example and adds another layer of complexity to this process. In the last few years, many issues have emerged such as the treatment of pension costs and contracted labor. If all this was not enough, CMS is proposing significant reform to wage index that may or may not make this process simpler. From my experience as the National Wage Index Team Leader, previously at Ernst & Young, now with Deloitte & Touche, I have worked with over 800 hospitals and every Fiscal Intermediary in the country. I will provide education on the regulations and documentation as well as real life stories and examples of what works and what does not work. I will walk through the current regulations as well as proposed reform. I will discuss all of the calculations and best practices to compile the appropriate supporting documentation. I always make my sessions interactive so that audience members can also share what they have experienced. I have done this session at ANI for the last 2 years and have had very good evaluations. I hope that you will consider me once again.