5th Circ. Says HHS Hospital Pay Policy Was Above Board

Law360 (April 20, 2020, 11:45 PM EDT) -- The U.S. Department of Health and Human Services lawfully issued a regulation adding new categories of payments that can be subtracted from supplemental payments to hospitals disproportionately serving poor patients, the Fifth Circuit ruled Monday, reversing a win for a group of hospitals challenging the rule.

A three-member panel said a lower court improperly granted summary judgment to eight Mississippi hospitals alleging the 2017 rule violated the Medicaid Act by disregarding the law's requirement that the so-called disproportionate share hospital payments can only be calculated by subtracting Medicaid payments from the cost of services for Medicaid patients.

While the hospitals argued...

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