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).