Dynamic List Information
Dynamic List Data
Decision Number
2007-D78
Case Name
Santa Barbara Cottage Hospital vs. BlueCross BlueShield Association/ National Government Services, LLC - CA
Issue
1. Whether the Intermediary improperly disallowed direct graduate medical education (DGME) and indirect medical education (IME) payments with respect to discharge of Medicare beneficiaries who were enrolled in the Medicare + Choice or other Medicare risk plans in fiscal years ending December 31, 1998, 1999, 2000 and 2001. 2. Whether the Intermediary improperly disallowed residents' time spent in non-provider settings within the scope of the Provider's approved medical residency training programs from the Provider's full-time equivalent resident counts for DGME and IME purposes.