The Centers for Medicare & Medicaid Services Aug. 4 released a proposed rule that would retroactively incorporate Medicare Advantage days into the Medicare fraction of a hospital’s disproportionate patient percentage for the Medicare Disproportionate Share Hospital program.

CMS has included MA days in the Medicare fraction since finalizing the policy in the fiscal year 2014 inpatient prospective payment system final rule.

In today’s rule, CMS proposes to retroactively include MA days in the Medicare fraction for discharges before Oct. 1, 2013, the effective date of the FY 2014 inpatient PPS final rule. It previously vacated the policy for the time period before Oct 1, 2013 in light of legal challenges, including a ruling by the Supreme Court.

“The effect of this proposed rule would be to avoid the consequences of legal ambiguity that would otherwise continue into the future,” CMS said. Comments are due 60 days after the rule’s Aug. 6 publication in the Federal Register.

Related News Articles

Headline
The AHA April 30 released a report highlighting how hospitals and health systems continue to experience significant financial headwinds that can challenge…
Headline
The Supreme Court April 29 ruled 7-2 in favor of the Department of Health and Human Services in a case that challenged how HHS applied Congress’ formula for…
News
The Centers for Medicare & Medicaid Services April 7 released finalized payment rates for calendar year 2026 Medicare Advantage and Part D plans. Payments…
Headline
The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2026. The…
Headline
The AHA March 11 shared ways Congress could better support patient access to post-acute care in comments for a hearing held by the House Committee on Ways and…
Headline
A new AHA report highlights how certain practices by Medicare Advantage plans are increasing rural hospitals' vulnerabilities and threatening access to care in…