US EditionSupreme Court decides Medicare reimbursement calculation
- On Tuesday, the Supreme Court issued a 7-2 ruling in favor of the Department of Health and Human Services in a dispute involving Medicare reimbursement formulas for over 200 hospitals in 30 states that serve a high number of low-income patients.
- The dispute arose because hospitals sought to change how Medicare calculates disproportionate share hospital payments for treating low-income patients, challenging a lower court’s restriction to patients receiving Supplemental Security Income payments monthly.
- Justice Amy Coney Barrett wrote the majority opinion emphasizing that the law requires counting only patients who actually receive SSI cash benefits in the hospitalization month, rejecting hospitals’ broader view including non-cash or enrolled-but-not-paid patients.
- Justice Ketanji Brown Jackson dissented with Justice Sotomayor, arguing the majority’s focus on monthly payments ignores the Social Security program’s realities and quoting its interpretation as “illogic” that misrepresents congressional intent.
- The ruling upholds the current formula, potentially affecting over $4 billion in payments to safety-net hospitals, which remain critical for serving low-income patients but face ongoing reimbursement challenges.
18 Articles
18 Articles
Supreme Court Rules That Hospitals Serving the Poor Ineligible for Medicare Increases
The Supreme Court ruled 7-2 on April 29 that hospitals that serve large numbers of poor people are not eligible for higher Medicare payments from the government. Justice Amy Coney Barrett wrote the majority opinion in Advocate Christ Medical Center v. Kennedy. It was joined by Justices Clarence Thomas, Samuel Alito, Neil Gorsuch, Brett Kavanaugh, and Elena Kagan, as well as Chief Justice John Roberts. Acknowledging the statute governing the Medi…
Supreme Court sides with HHS on formula used to pay hospitals for treating low-income patients
The Supreme Court on Tuesday rejected hospitals’ argument that the federal government doesn’t pay them enough for treating low-income patients. The seven-justice majority instead sided with the Department of Health and Human Services’ interpretation of the law concerning disproportionate share hospital, or DSH, payments, which compensate hospitals for treating low-income patients. More than 200 hospitals brought the case, Advocate Christ Medical…
Justice Ketanji Brown Jackson says Supreme Court ruling will hurt the ‘neediest among us’
The “neediest among us” will suffer due to a new Supreme Court decision, according to Justice Ketanji Brown Jackson’s dissent from the ruling. Joined by Justice Sonia Sotomayor, Jackson said Congress can fix the issue.
The Columbian
Supreme Court decides Medicare reimbursement calculation
WASHINGTON — The Supreme Court sided on Tuesday with the Department of Health and Human Services in a dispute over the rate under Medicare the government pays to hospitals that serve low-income patients. Read more...
SCOTUS delves into hospital low-income patient reimbursement – Rhode Island Lawyers Weekly
For purposes of calculating adjustments to the rates the Department of Health & Human Services pays hospitals for providing inpatient treatment to heightened percentages of low-income individuals, a patient is entitled to supplemental security income with respect to statutorily prescribed “Medicare fraction” of the agency’s calculation when she is eligible to receive an SSI cash Supreme Court rules SSI eligibility hinges on receiving cash paymen…
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