A new group counts only where the hospital's costs exceed all payments
What the document says“``(iii) Individuals who are eligible for medical assistance under the State plan or under a waiver”
Section 6106 adds a new clause (iii) to section 1923(g)(1)(B) of the Social Security Act. It covers individuals eligible for medical assistance under the State plan or a waiver for whom the plan or waiver pays after Medicare or an applicable plan, but only if the hospital in the aggregate incurred costs exceeding the payments from all of those sources for services furnished to those individuals during the year.
What the document actually says“``(iii) Individuals who are eligible for medical assistance under the State plan or under a waiver”
This covers people who can get help under the state plan or a waiver of it.
These are people with more than one payer. The hospital may count them only if its costs were more than all it was paid for them.
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