(March 3, 2023) – The Centers for Medicare & Medicaid Services released a
proposed rule that would clarify the regulations about counting the days associated with a
section 1115 demonstration waiver within the Medicaid fraction of a hospital's Medicare disproportionate patient percentage. The rule regards Medicaid-eligible for the purposes of Medicare Disproportionate Share Hospital payment adjustment calculations for patients who receive health insurance through a section 1115 demonstration itself or patients who purchase health insurance with the use of premium assistance provided by a section 1115 demonstration.
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Shannan Flach