For the last few weeks, we have been focusing on the Medicare DSH payment and how the payment calculation changed due to ACA.
Medicare DSH is a process that involves much more than the payment amount found on the cost report for WHAT the hospital should be paid. Now, there are new external factors beyond the calculation that may affect IF the hospital gets paid. The Medicare DSH game is changing and a clear message is being sent that Medicare Disproportionate Share as we know it has changed.
This is evident with the:
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2015 IPPS proposed rule language covering the substantive requirement to claim costs
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Issuance of the PRRB’s Alert 10
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Trends in recent PRRB jurisdictional decisions