Dynamic List Information
Dynamic List Data
Decision Number
PRRB Dec. No. 2011-D20
Case Name
QRS 1995-1998 DSH Medicare HMO Days Groups vs. Blue Cross Blue Shield Association; Noridian Administrative Services - National Government Services - Trailblazer Health Enterprises
Issue
Whether for fiscal years 1995-1998 the Intermediary should include dual-eligible, Medicare health maintenance organization (HMO) patient days in the Medicaid proxy in determining Medicare reimbursement for disproportionate share hospital (DSH) payments in accordance with the Medicare statute at 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II).