DSH

CMS Prevails in DSH Challenge Involving Waiver-Expansion Days

by Thomas W. Coons | Ober|Kaler on 5/22/2013

Over the years, CMS and its contractors have wrestled with how days approved under a Medicaid demonstration project should be counted, if at all, for purposes of the Medicare disproportionate share hospital (DSH) calculation....more

Hospitals Prevail in Effort to Include Pennsylvania GA Days in the Medicare DSH Calculation

by Gregory Fliszar, Mark Gallant | Cozen O'Connor on 5/1/2013

Two of Mercy Health System’s hospitals (Nazareth Hospital and the former St. Agnes Medical Center) successfully challenged, before Judge Ludwig of the U.S. District Court for the Eastern District of Pennsylvania, the...more

Court Grants Unexpected Victory to Providers on Medicare DSH Adjustment

by Thomas W. Coons, Mark A. Stanley | Ober|Kaler on 4/18/2013

The United States District Court for the Eastern District of Pennsylvania’s opinion in Nazareth Hosp. v. Sebelius, slip op. no. 10-3513 furnished a surprising victory to two providers that challenged the calculation of the...more

President’s Budget Proposes to “Clarify” that the DSH Medicare Fraction Includes Exhausted and MA Days

by King & Spalding on 4/17/2013

The President’s proposed budget for FY 2014, released last week, includes a line item at page 197 that proposes to "Clarify the Medicare Fraction in the Medicare Disproportionate Share Hospital (DSH) statute." This line item...more

The New DSH - Are You Supplying The Correct Data That Will Drive Your Payments?

by Leslie Demaree Goldsmith | Ober|Kaler on 4/8/2013

Effective October 1, 2013, CMS will begin paying disproportionate share hospitals differently. Congress ordered the change to the disproportionate share hospital (DSH) adjustment payment methodology as part of the Patient...more

Court of Appeals Rules for Government in DSH Exhausted Benefit Day Appeal

by Thomas W. Coons | Ober|Kaler on 4/5/2013

For the last several years, hospitals and the government have fought hard over where days associated with certain “dual eligible” patients should be placed in the Medicare disproportionate share hospital (DSH) calculation. At...more

Health Reform + Related Health Policy News Update - January 24, 2013

by Colleen M. Faddick, Bruce A. Johnson, Matthew Murer, Alan K. Parver | Polsinelli on 1/25/2013

In This Issue: - OMB Directs Department Heads to Prepare for Sequestration - HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements - SCOTUS Says Equitable Tolling Not a Factor in DSH Case - Report...more

Bolstered By Favorable District Court Decision, King & Spalding Now Forming Group Appeals Contesting Inclusion of Part C Days in...

by King & Spalding on 12/18/2012

In a recent decision for which King & Spalding organized the appealing group of hospitals and was co-counsel, the D.C. district court ruled that CMS’s regulation requiring the inclusion of Medicare Part C patient days in the...more

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