2011-D36

Dynamic List Information
Dynamic List Data
Decision Number
2011-D36
Case Name
Southern Christian Medical Center vs. BlueCross BlueShield Association/First Coast Service Options, Inc. - Fl (formerly Cooperativa de Seguros de Vida de Puerto Rico)
Issue
Whether the Intermediary improperly excluded certain days attributable to Puerto Rico Medicaid enrollees who were classified by the Administration De Seguros De Salute De Puerto Rico as category six, for which Puerto Rico receives no Federal matching funds in computing the fraction reflecting the percentage of inpatients who were entitled to medical assistance under an approved state plan (the Medicaid fraction) for purposes of the Medicare disproportionate share hospital calculation.

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