PRRB Review

Decision #
2011D20
Case #
08-2752GC; 04-2131G; 04-2132G; 04-2133G; 04-2134G; 08-2845GC; 08-2756GC
Provider #
Various
Issue
Whether for fiscal years 1995-1998 the Intermediary should include dual-eligible, Medicare health maintenance organization (HMO) patient days in the Medicaid proxy in determining Medicare reimbursement for disproportionate share hospital (DSH) payments in accordance with the Medicare statute at 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II).
Case Name
QRS 1995-1998 DSH Medicare HMO Days Groups
Decision Date
03/16/2011
Fiscal Year End
Various