Hospital Insurance (Part A); Jurisdiction over Appeals of Disproportionate Share Hospital Payments Involving Challenges to the Treatment of Part C Days in the SSI and Medicaid Fractions for Cost Reports With Discharges before October 1, 2013.
This Ruling provides notice of how the Centers for Medicare & Medicaid Services (CMS) will handle certain administrative appeals in response to the decision of the United States Supreme Court in Azar v. Allina Health Services, 139 S. Ct. 1804 (June 3, 2019). In that case, the Supreme Court held that section 1871(a)(2) of the Social Security Act (the Act) required CMS to engage in notice-and-comment rulemaking before adopting a policy of including beneficiaries enrolled in Part C in the Medicare
fraction (also referred to herein as the SSI fraction), for purposes of calculating a hospital’s disproportionate patient percentage for cost years when there was no governing regulation in place.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 17, 2020
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