Hospitals may gain some simplified rules regarding the counting of Medicaid

days beginning in federal fiscal year 2010. As we noted in the May 14, 2009

edition of Payment Matters, CMS's FY 2010 Inpatient Prospective Payment

System (IPPS) Proposed Rule offers some changes to the way that patient

days are counted in the Disproportionate Share Hospital (DSH) adjustment.

See "CMS Publishes Inpatient Prospective Payment System (IPPS) FY

2010 Proposed Rule," Payment Matters, May 14, 2009.

Specifically, the proposed rule includes bright line tests for the counting of

observation beds for DSH and indirect medical education (IME) purposes, and

for the counting of labor and delivery room days for DSH purposes. The

proposed rule would also give hospitals several options with respect to

reporting the number of patient days attributable to Medicaid eligible patients

for DSH purposes. If adopted, these new tests would apply to cost reporting

periods beginning on or after October 1, 2009. Leslie Demaree Goldsmith and Mark Stanley of Ober|Kaler look at some of the details.