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Audit (A-03-08-00203)

Review of Pennsylvania's Determination of Medicaid Disproportionate Share Hospital Eligibility for the State-Operated Institutions for Mental Diseases

Executive Summary

The State agency included unallowable patient days for Medicaid beneficiaries between the ages of 22 and 64 and incarcerated individuals in its calculations of disproportionate share hospital (DSH) eligibility for its eight State-operated institutions for mental diseases (IMD). The Office of Inspector General (OIG) removed the unallowable patient days from the DSH eligibility calculations. Even with these exclusions, each of the eight IMDs qualified for a DSH payment.

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