CMS issued a proposed rule on Tuesday that has to do with how it calculates Medicare disproportionate-share hospital payment adjustments for hospitals serving a large number of low-income patients.
To square with the law, the agency proposed including Medicare Advantage patient days in the Medicare fraction of the DSH payment adjustment calculation for fiscal years before 2014.
This is the same policy that CMS adopted in its 2005 inpatient prospective payment system rule but was later vacated by a District Court in 2012 because it didn't engage in notice-and-comment rulemaking.
The U.S. Supreme Court in 2019 also considered a challenge to the agency's policy regarding the treatment of Medicare Advantage patient days in the Medicare fractions it published for 2012. The court held that CMS was required to engage in notice-and-comment rulemaking.
CMS does not expect the proposed rule issued Tuesday to have any effect on payments because the payments previously made already reflect the proposed policy.