CHA News Article

CMS Proposes Rule to Retroactively Include Medicare Advantage Days in Medicare DSH Calculation
For CFOs, finance staff, government relations executives

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would retroactively incorporate Medicare Advantage (MA) days into the Medicare fraction of a hospital’s disproportionate patient percentage for the Medicare disproportionate share hospital (DSH) program. 

Specifically, the proposed rule would retroactively include MA days in the Medicare fraction for discharges before Oct. 1, 2013. CMS has previously finalized the inclusion of MA days in the Medicare fraction prospectively beginning with federal fiscal year 2014.  

The proposed rule is intended to address the ruling in Azar v. Allina Health Services, which required that CMS engage in notice-and-comment rulemaking before adopting its policy on treatment of inpatient days for beneficiaries enrolled in MA plans for purposes of calculating the disproportionate patient percentage.

Comments on the proposed rule are due Oct. 5.  

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