42 U.S.C. § 1395mm(a)(6). Instead, the private HMO was obligated to make payment for Medicare- covered hospital stays by such individuals.16 42 U.S.C. § 1395mm(c)(2)(A)(i). In contrast, payments under Part A (which would entitle a patient to be counted in the GME formula) are made on the patient’s behalf directly to hospitals or similar health care providers.

35,990, 35,994 (Sept. 4, 1990), the 33 The Medicare Act authorized the Secretary to enter into contracts with HMOs and other risk- bearing entities under which the Secretary paid the HMOs capitation rates per enrollee in lieu of amounts that would otherwise be paid to hospitals under Medicare Part A through the Medicare fiscal intermediaries. See 42 U.S.C. §§ 1395mm(a)(1) and (a)(3); 42 C.F.R. §§ 417.524 and 417.

This entitlement is a precondition to HMO enrollment, and ceases upon enrollment. See 42 U.S.C. § 1395mm(a)(6) (only the HMO is entitled to receive payments from the Secretary under Part A for services furnished to a Medicare enrollee). In any event, even if the Secretary considers HMO enrollees to be “entitled to benefits under Part A” for purposes of the Medicare HMO statute, the Secretary did not construe that phrase to have the same meaning for purposes of the DSH statute during the period at issue.

This entitlement is a precondition to HMO enrollment, and ceases upon enrollment. See 42 U.S.C. § 1395mm(a)(6) (only the HMO is entitled to receive payments from the Secretary under Part A for services furnished to a Medicare enrollee). In any event, even if the Secretary considers HMO enrollees to be “entitled to benefits under Part A” for purposes of the Medicare HMO statute, the Secretary did not construe that phrase to have the same meaning for purposes of the DSH statute during the period at issue.