Hospitals must protect their rights to pending reimbursement revenue by protesting issues on the cost report, collecting detailed documentation and filing timely appeals. SCA, in conjunction with various legal firms, assists hospitals in documenting days at issue as well as developing and supporting arguments to be pursued via the Provider Reimbursement Review Board (PRRB) and U.S. Court system.

Most notably, SCA pursued Northeast v. Sebelius, resulting in the favorable decision for the hospital community regarding both Medicare+Choice days for periods prior to 10/01/04 as well as Labor and Delivery days. Both resulted in the inclusion of additional days in the Medicaid fraction of the DSH reimbursement calculation. Further, SCA pursued Baystate v. Leavitt, also resulting in a favorable decision regarding prior errors and omissions from the Medicare SSI percentage, a component of the DSH reimbursement calculation.