Two Major DSH Decisions
Two important decisions addressing disproportionate share hospital (DSH) adjustments were recently issued.
DSH Medicaid Eligible Days Used in the Medicaid Proxy
On April 23, 2006, the United States Supreme Court denied certiorari, i.e., declined to review the decision of the United States Court of Appeals for the District of Columbia in Leavitt v. Baystate Health Systems, 414 F.3d 7 (D.C. Cir. 2005). As a result, the Court of Appeals' decision stands as controlling law. That court held that intermediaries had a nondiscretionary duty to reopen certain hospitals' Medicare cost reports and recalculate their DSH payments to include Medicaid eligible but unpaid days even if the providers did not request the reopening. At the time of this writing, counsel for providers with similar pending cases and CMS counsel are discussing potential settlement of this issue for these providers.
DSH Supplemental Security Income (SSI)
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