Dive Brief:
- Upwards of 400 hospitals have settled with the federal government for undisclosed amounts after challenging how HHS determines disproportionate-share hospital (DSH) payments, Modern Healthcare reported.
- Medicaid programs are required by federal law to make DSH payments to qualifying hospitals serving large populations of Medicaid and uninsured patients.
- The hospitals that settled are from four of the five plaintiff hospital groups that brought claims, though some hospitals have refused to settle either at all or for particular years during the timeframe contested (fiscal years 1992 through 2004).
Dive Insight:
Little could be gleaned for the implications as of Friday, given that no terms or settlement amounts were disclosed.
The hospitals and systems that settled included Catholic Health Initiatives, Beth Israel Deaconess Medical Center, St. Elizabeth's Medical Center, and UMass Memorial Health Care, Modern Healthcare noted.
The claims were brought in 2010 when the hospitals sought a review of DSH payments from 1992 through 2004, for which they said HHS had incorrectly reduced their payments by categorizing dual-eligible patients as eligible for Medicare benefits rather than Medicaid benefits, which lowered their low-income patient rate.
The remaining hospital group was granted addtional time to try to negotiate a settlement before the case proceeds.
Legal news website Law360 reported the settlements represented about 430 hospitals and 1,700 cost years of DSH payments, averaging roughly four cost years per hospital.