TYPE OF DAY - General Assistance
Patient Days
DESCRIPTION - Days for patients covered under a State-only (or countryonly)
general assistance program (whether or not any
payment is available for health care services under the
program). These patients are not Medicaid-eligible
under the State plan.
TYPE OF DAY - Other State-Only Health
Program Patient Days
DESCRIPTION - Days for patients covered under a State-only health
program. These patients are not Medicaid-eligible
under the State plan.
TYPE OF DAY - Charity Care Patient
Days
DESCRIPTION -Days for patients not eligible for Medicaid or any other
third-party payer, and claimed as uncompensated care
by a hospital. These patients are not Medicaid-eligible
under the State plan.
TYPE OF DAY - Actual 1902(r)(2) and
1931(b) Days
DESCRIPTION -Days for patients eligible under a State plan based on a
1902(r)(2) or 1931(b) election. These patients are
Medicaid-eligible under the Title XIX State plan under
the authority of these provisions, which is exercised by
the State in the context of the approved State plan
TYPE OF DAY - Medicaid Optional
Targeted Low-Income
Children (CHIP-related)
Days
DESCRIPTION -Days for patients who are Title XIX-eligible and who
meet the definition of "optional targeted low-income
children" under §1905(u)(2). The difference between
these children and other Title XIX children is the
enhanced FMAP rate available to the State. These
children are fully Medicaid-eligible under the State
plan.
TYPE OF DAY - Separate CHIP Days
DESCRIPTION -Days for patients who are eligible for benefits under a
non-Medicaid State program furnishing child health
assistance to targeted low-income children. These
children are, by definition, not Medicaid-eligible under
a State plan.
TYPE OF DAY - §1915(c) Eligible Patient
(the "217" group) Days
DESCRIPTION -Days for patients in the eligibility group under the State
plan for individuals under a Home and Community
Based Services waiver. This group includes individuals
who would be Medicaid-eligible if they were in a
medical institution. Under this special eligibility group,
they are Medicaid-eligible under the State plan.
TYPE OF DAY - Retroactive Eligible Days
DESCRIPTION -Days for patients not enrolled in the Medicaid program
at the time of service, but found retroactively eligible
for Medicaid benefits for the days at issue. These
patients are Medicaid-eligible under the State plan
TYPE OF DAY - Medicaid Managed Care
Organization Days
DESCRIPTION -Days for patients who are eligible for Medicaid under a
State plan when the payment to the hospital is made by
an MCO for the service. An MCO is the financing
mechanism for Medicaid benefits, and payment for the
service through the MCO does not affect eligibility
TYPE OF DAY - Medicaid DSH Days
DESCRIPTION -Days for patients who are not eligible for Medicaid
benefits, but are considered in the calculation of
Medicaid DSH payments by the State. These patients
are not Medicaid-eligible
Sometimes Medicaid State plans specify that Medicaid
DSH payments are based upon a hospital's amount of
charity care or general assistance days. This, however,
is not "payment" for those days, and does not mean that
the patient is eligible for Medicaid benefits or can be
counted as such in the Medicare formula
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