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Seventh Circuit allows research time in IME FTE count

USA - September 30 2010 The Seventh Circuit recently ruled that "pure research time" must be included in a provider's fiscal year 1996 full time equivalent (FTE) resident count for purposes of the Medicare indirect medical education (IME) adjustment.

Medicare DSH alert: CMS finalizes new SSI ratio methodology

USA - September 2 2010 In the preamble to the final inpatient prospective payment system (IPPS) rule, the Centers for Medicare & Medicaid Services (CMS) finalized its proposed methodology for calculating providers' SSI Ratios (aka Medicare Fractions) for purposes of the Medicare disproportionate share hospital (DSH) adjustment.

Gregory N. Etzel.

CMS proposes implementation of major GME changes

USA - July 22 2010 The proposed OPPS update and ASC payment changes rule for calendar year 2011 contains multiple regulatory proposals implementing the changes to Medicare graduate medical education (GME) reimbursement enacted by PPACA.

Gregory N. Etzel.

SSI ratio - court holds no judicial recourse for untimely appeal

USA - March 4 2010 On February 26, 2010, the District Court for the District of Columbia ruled against a group of providers who attempted to capitalize after the fact on the provider-friendly ruling in the Baystate case (in which the Provider Reimbursement Review Board (PRRB or Board) held that the SSI Ratios used to compute providers' disproportionate share hospital (DSH) adjustments were systemically flawed).

IME resident research time: another district court weighs in

USA - January 21 2010 On December 30, 2009, the District Court for the Eastern District of Michigan joined numerous district courts in ruling that resident research time must be included in a hospital's full-time equivalent (FTE) resident count for purposes of indirect medical education (IME) reimbursement during time periods prior to 2001.