Hospitals sue HHS over disproportionate share hospital payment
Eighty hospitals want a reversal of a final rule that includes Medicare Advantage in payment calculations.
September 13, 2024-Susan Morse, Executive Editor –
Eighty hospitals have sued the Department of Health and Human Services over disproportionate share hospital payments that include calculations for Medicare Advantage.
The action was filed Monday in the U.S. District Court for the District of Columbia by the Cleveland Clinic and other hospitals in Ohio, several Texas Health hospitals, Huntington Beach Hospital and other hospitals in California, Mercy Hospitals in several states, and other hospitals in New Jersey, Rhode Island, Arkansas, Alabama, Louisiana, Michigan, Kansas, Oklahoma, Missouri, Pennsylvania, Nevada, Washington and Hawaii.
The civil action stems from how the Centers for Medicare and Medicaid Services determines inpatient days in calculations for disproportionate share hospital payments for providers that serve vulnerable populations.
Hospitals are losing billions, according to the lawsuit.
Litigation has been ongoing for about 16 years.
In a previous ruling, the lawsuit said, “The court also explained that the inclusion of Part C days in the Medicare fraction ‘makes the fraction smaller and reduces hospitals’ payments considerably – by between $3 and $4 billion over a 9-year period, according to the government.'”
