Tag Archives: disproportionate-share payments

Hospitals, HHS each scored a win and a loss in recent Supreme Court cases

Photo by Geoff Livingston via Flickr.

Amid issuing some of the most significant rulings this century, the U.S. Supreme Court (SCOTUS) also decided on two cases where certain hospitals challenged federal decisions that cost them money. 

Hospitals scored one win and one loss in these cases. Both cases involved Department of Health and Humans Services (HHS) policies created under Republican presidents that the Biden administration sought to defend. 

In Health and Human Services Secretary (HHS) Becerra v. Empire Health Foundation, the Supreme Court split 5-4 in a June 24 decision about a calculation used to decide which hospitals qualify for extra pay for serving many people with low incomes. The Supreme Court found in favor of HHS in this case, disappointing hospital groups.

On June 15 in the American Hospital Association (AHA) v. Becerra case, the Court said in a unanimous decision that HHS erred in the administrative procedures in cutting reimbursement on certain drugs. In this case, the Biden administration had defended a Trump administration bid to compel hospitals to share certain savings they get on medicines with Medicare and people enrolled in the program.

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Cost reports show financial health of hospitals, amount of charity care they provide

Clifton Adcock

Clifton Adcock

Oklahoma Watch, a nonprofit investigative journalism team, recently published a two-part series on hospitals based on financial data obtained for every hospital in the state. As reporter Clifton Adcock writes in an article for AHCJ, the series revealed that between half and three-fourths of small general hospitals in Oklahoma were losing money, and that hospitals had spent only small fractions of their net patient revenues on charity care.

Hospitals get “disproportionate-share” (DSH) payments from the federal government to help cover costs for treating the indigent. Because Oklahoma was not expanding Medicaid under the Affordable Care Act, hospital groups said they expected to take a big financial hit from the law’s cuts to DSH payments. Oklahoma Watch wanted to see how much they relied on such payments. Continue reading