On March 6, 2009, the Centers for Medicare and Medicaid Services (CMS) issued Change Request 6329, which requires non-teaching prospective payment system (PPS) hospitals that received Medicare disproportionate share hospital (DSH) payments in FY 2006 and inpatient rehabilitation facilities (IRFs) that received low income patient (LIP) payments in FY 2006 to submit informational-only bills to their Medicare contractors for Medicare Advantage (MA) beneficiaries that were treated between October 1, 2005, and September 30, 2006. This documentation will allow CMS to ensure that MA patient days are included in the DSH and LIP payment calculations for FY 2006. Inpatient prospective payment system (IPPS) hospitals and IRFs that did not receive a DSH or LIP payment for FY 2006 are not required to submit claims, although they may choose to do so. Teaching hospitals are not required to submit this documentation to their contractors because they already should have submitted MA claims as a part of the indirect medical education (IME) reimbursement process. Affected hospitals must submit their FY 2006 claims to their contractors between July 1, 2009, and November 30, 2009. With respect to the Medicare DSH calculation, CMS intends to include the MA days in the Medicare fraction of the Medicare DSH calculation, based on the agency's belief that "such patients by definition are entitled to Medicare Part A."

Change Request 6329 has resulted in revisions to Ch. 3 sections 20.3 and 140.2.4.3 of the Medicare Claims Processing Manual. MedLearn Matters article MM6329 also discusses these FY 2006 requirements.