- A judge ruled against dozens of hospitals that sued HHS over payment changes for hospitals that treat a large share of low-income patients, known as disproportionate share hospital payments.
- The federal judge sided with HHS, pointing to a specific portion of the Medicare Act that prohibits any administrative and judicial review of how the department arrived at its calculations, according to a ruling this week by Chief Judge Beryl Howell of the U.S. District Court for the District of Columbia.
- Howell's summary judgment upholds HHS' DSH calculations, marking a loss for the 48 plaintiff hospitals, which include some Ascension facilities.
At the center of the controversy is HHS' move to rely on a specific data report, worksheet S-10, to calculate a hospital's uncompensated care.
The plaintiff hospitals argued the use of "the inappropriate data has eviscerated the purpose of assisting hospitals who treat a disproportionate amount of indigent patients," according to the suit filed in 2020.
The hospitals allege their DSH payments were negatively affected by the change. They took their initial complaint to the administrative review board, known as the Provider Reimbursement Review Board, which sided against the hospitals.
The hospitals then sought relief by turning to the federal courts.
But Howell did not grant any relief. Ultimately, she found that the hospitals' desire to recalculate those payments was outside of her review per the Medicare Act.
To rule otherwise would mean "... eviscerating the statutory bar and undercutting Congress's express language insulating the estimates from review," Howell's opinion said.
How HHS calculates DSH payments has been hotly contested over the years.
One recent case even made to the Supreme Court where the justices ruled against HHS, favoring hospitals. The justices said HHS violated the law without providing hospitals with notice and an opportunity to comment on DSH payment cuts.
The Supreme Court is set to hear another DSH case this upcoming term, which centers on a dispute in the DSH calculation and was brought by Empire Health Foundation.