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As part of the federal fiscal year 2024 inpatient prospective payment system final rule, the Centers for Medicare & Medicaid Services (CMS) also finalized its proposal to limit how Medicaid 1115 demonstration days count for purposes of the Medicare disproportionate share hospital (DSH) calculation.
In the final rule, CMS will only count, for purposes of the Medicare DSH calculation, the days of patients who receive from the state’s Section 1115 demonstration health insurance that covers inpatient hospital services or premium assistance that covers 100% of the premium cost for a patient who buys health insurance that covers inpatient hospital services, provided that the patient is not also entitled to Medicare Part A.
The rule is effective Oct. 1.
