HHS settles with 400 hospitals in uncompensated care case

More than 400 hospitals have reached a settlement with HHS for an undisclosed amount of money over disputed reimbursements for disproportionate share hospital (DSH) payments, which go to facilities who serve a large number of low-income patients.

The suit, Alegent Health-Bergan Mercy Health System, et al. v. Burwell, began in 2010 and covers disputed DSH claims dating back to 1992. Hospitals argued HHS unfairly reduced reimbursements by categorizing patients eligible for both Medicaid and Medicare as only Medicare-eligible, lowering the low-income patient rate used to calculate DSH payments.

The terms of the settlement aren’t being publicly disclosed, with the exception that both sides will be covering their own legal fees. According to legal news site Law360, approximately 1,700 cost years of DSH payments are covered by the settlement, amounting to about four cost years per hospitals.

Among the hospitals involved in the lawsuit are Catholic Health Initiatives, Southcoast Hospital Group, Miriam Hospital in Providence, Sisters of Charity Hospital in Buffalo and Beth Israel Deaconess Medical Center in Boston. 

""
John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”