PRRB Dec. No. 2008-D07

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Decision Number
PRRB Dec. No. 2008-D07
Case Name
St. Marys Hospital - Milwaukee vs. BlueCross BlueShield Association/National Government Services, LLC-WI
Issue
1. Whether CMS properly calculated the Provider's Medicare disproportionate share hospital (DSH) adjustment by not including 52 patient days from the Supplemental Security Income (SSI) fraction. 2. Whether the Intermediary improperly calculated the Providers Medicare DSH adjustment by excluding 366 Long Term Respiratory Unit (LTRU) patient days from the Medicaid proxy of the DSH calculation.

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