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Decision #
2015D07
Case #
06-0686; 07-1177; 08-1362
Provider #
10-0061
Issue
Issue 1: Whether the Provider Reimbursement Review Board ("Board") has jurisdiction to review the Medicare Contractor's determination that the days of patients who were both eligible for medical assistance under an approved Medicaid state plan and enrolled in a Medicare+Choice plan under Part C of the Medicare program should be excluded from the Medicaid fraction of the low-income payment adjustment for Mercy Hospital. Issue 2: Whether the Medicare Contractor properly determined Mercy Hospital's low-income percentage adjustment under the propsective payment system for rehabilitation facilities for fiscal years 2002, 2003, and 2004. In particular, the Medicare Contractor excluded from the Medicaid fraction of the low-income payment adjustment, the days of patients who were both eligible for medical assistance under an approved Medicaid state plan and enrolled in a Medicare+Choice plan under Part C of the Medicare program
Case Name
Mercy Hospital, Miami, Florida
Decision Date
April 3, 2015
Fiscal Year End
12/31/2002; 12/31/2003; and 12/31/2004