PRRB Dec. No. 2011-D40

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Decision Number
PRRB Dec. No. 2011-D40
Case Name
UMass Health System 2004 DSH Medicare+Choice Group vs. BlueCross BlueShield Association/NHIC Corp., c/o National Government Services, LLC
Issue
Whether inpatient days for Medicaid-eligible patients who were enrolled in Medicare+Choice (M+C) plan under Part C of the Medicare statute were properly excluded from the numerator of the Medicaid fraction that is used to calculate the disproportionate share hospital (DSH) payment.

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