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Original Policy (CMS)




1  Types of patient days under the CMS appeal ruling (SSI days):

  • Included in SSI days (numerator):

  • Days which were covered and paid under Medicare Part A and the patient was entitled to SSI benefits;

  • Included in as total Medicare Part A days (denominator):

  • Medicare Part A — only covered days are included.

  • Non-covered or exhausted inpatient days were included in the Medicaid fraction denominator.

  • Excluded from SSI Days (numerator):

  • Non-covered inpatient hospital days for patients entitled to Medicare Part A, including days for which the patient"s Part A inpatient hospital benefits were exhausted, were excluded from the numerator of the DSH Medicaid fraction (even when the patient was eligible for Medicaid).

  • Excluded from total Medicare Part A days (denominator).