CMS Ruling No: 1498-RDate: April 28, 2010
1 Jurisdiction over appeals of Disproportionate Share Hospital (DSH) payments, and recalculations of
DSH payments following remands from administrative tribunals.
Appeals of the data matching process used in calculating the SSI fraction.
Appeals of exclusion from the DPP of non-covered inpatient hospital days for patients entitled to Medicare Part A, and days for which the patient's Part A inpatient hospital benefits were exhausted.
Appeals of the exclusion from the DPP of Labor/Delivery Room inpatient days.
The Standard Implementation Procedure.
The Alternative Implementation Procedure.
"Mixed" appeals where some claims are, but other claims are not, subject to the ruling.
Requests for review of a finding that a claim is not subject to the ruling.
Appeals on the SSI data matching process issue.
Appeals on non-covered inpatient day or exhausted benefit day issues.
Appeals on the Labor/Delivery Room inpatient day issue.
Cost reports not settled finally by an initial NPR.
Provision for unitary relief on all three DSH issues.