PRRB Dec. No. 2018-D41

Whether the Medicare Administrative Contractor determined Medicare reimbursement for Disproportionate Share Hospital (DSH) payments in accordance with the Medicare statute, 42 U.S.C. § 1395ww(d)(5)(F)(vi). Specifically, whether the numerator of the “Medicaid fraction” properly includes all “eligible” Medicaid days, regardless of whether such days were paid days.