Tuesday, June 04, 2019

In a win for rural areas, high court nixes Medicare reductions to hospitals whose patients are disproportionately poor

The U.S. Supreme Court ruled Monday that the Department of Health and Human Services improperly changed the Medicare reimbursement formula for "disproportionate share hospitals," which receive more money because they treat a disproportionate share of poor people. That's good news for rural hospitals, which are overall more dependent on so-called DSH payments.

"In a 7-1 decision, the justices said HHS needed a notice-and-comment period for the Medicare DSH calculation change," Susannah Luthi reports for Modern Healthcare. "Justice Neil Gorsuch wrote in the decision that HHS' position for not following the procedure was 'ambiguous at best.'"

Gorsuch wrote that, because Medicare is such a large program, even small changes can make a big difference in millions of lives and need to be considered carefully. "Because affected members of the public received no advance warning and no chance to comment first, and because the government has not identified a lawful excuse for neglecting its statutory notice-and-comment obligations, we agree with the Court of Appeals that the new policy cannot stand," he wrote. 

"Disproportionate Share Hospital cuts have been delayed several times since first scheduled in 2014, but had been set to take effect in 2020 — beginning with a reduction of $4 billion and increasing to $8 billion by 2025," Dana Elfin reports for Healthcare Dive.

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