Supreme Court decides Medicare reimbursement calculation [View all]
Source: Roll Call
Posted April 29, 2025 at 11:38am
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. The 7-2 decision rejected an attempt from a group of more than 200 hospitals across 30 states to change the formula the government uses to calculate reimbursement for hospitals that serve a disproportionate share of low-income patients.
The justices decided that the calculation hinges on how many patients received Social Security Supplemental Security Income program benefits in a given month, rather than the larger group that are enrolled in the program generally.
Justice Amy Coney Barrett, writing for the majority of the court, said that the phrase in the law specifying that the formula be based on patients “entitled” to the SSI benefit meant the portion of patients who actually received a check in the month they were hospitalized. “We must respect the formula that Congress prescribed,” Barrett wrote.
The hospital groups had asked the justices to overturn a decision from the U.S. Court of Appeals for the District of Columbia Circuit which issued a similar holding restricting the reimbursement calculation to those patients who received the SSI benefit.
Read more: https://rollcall.com/2025/04/29/supreme-court-decides-medicare-reimbursement-calculation/
The M$M completely ignored this story.
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