Disproportionate Share Hospital (DSH) Appeals Related To Medicare Advantage Days

InsightsClient Alert

The D.C. District Court’s recent decision in Allina Health Services v. Sebelius invalidated CMS’ regulation requiring Medicare Advantage days to be included in the Medicare fraction of the DSH computation. The removal of these days from the Medicare fraction typically increases the DSH payment. CMS has appealed the decision, but if it is upheld, CMS may be forced to revise the SSI percentages to remove any Medicare Advantage data.


Read More