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Decision #
2017D12
Case #
07-0413, 07-2872G, 09-1039GC, 09-1830G, 09-1863GC, 12-0365GC, 12-0373GC, 12-0412, 13-0140GC, 13-0591, 15-0266 and 15-0270
Provider #
Various
Issue
Whether Medicare Disproportionate Share Hospital (“DSH”) reimbursement calculations for the Providers (“Hospitals”) were understated due to the failure of the Centers for Medicare & Medicaid Services (“CMS”) and the relevant Medicare administrative contractors (“Medicare Contractors”)1 to include all supplementary security income (“SSI”) eligible patient days in the numerator of the Medicare fraction of the Medicare DSH percentage, as required by 42 U.S.C.§ 1395ww(d)(5)(F)(vi).
Case Name
Hall Render Individual, Optional and CIRP DSH Dual/SSI Eligible Group Appeals – Medicare Fraction
Decision Date
2017-03-28
Fiscal Year End
December 31, 2004 – June 30, 2009