Additional Instructions to Hospitals on the Election of a Medicare-SSI Component of the DSH Payment Adjustment for Cost Reports that Involve SSI Ratios for Fiscal Year (FY) 2004 and Earlier, or SSI Ratios for Hospital Cost-Reporting Periods for Patient Discharges Occurring Before October 1, 2004

Related Change Request (CR) Number: 10484
CR Release Date: September 6, 2019
CR Transmittal Number: R2357OTN
Effective Date: December 9, 2019
Implementation Date: December 9, 2019

CR 10484 directs MACs to inform hospitals of the additional instructions for making an election for a particular fiscal period covered by the Centers for Medicare & Medicaid Services' (CMS) Ruling 1498-R (as modified by CMS Ruling 1498-R2). Please make sure your cost report staffs are aware of these instructions.

On April 28, 2010, the Administrator of CMS issued CMS Ruling 1498-R, which addressed administrative appeals on three different issues related to Medicare Disproportionate Share (DSH) payment, which included the following:

  1. The Medicare-Supplementary Security Income (SSI) fraction data-matching process issue, and the method for recalculating the hospital's Medicare-SSI fraction by matching Medicare and SSI entitlement data
  2. The exclusion from the Medicare fraction and the numerator of the Medicaid fraction of non-covered inpatient hospital days for patients entitled to Medicare Part A, including days for which the patient's Part A inpatient hospital benefits were exhausted
  3. The exclusion from the DSH calculation of labor/delivery room (LDR) inpatient days. On April 22, 2015, the Administrator

View the complete CMS Change Request (CR)10484.


            Last Updated Mon, 09 Sep 2019 13:32:42 +0000