DSH Payment Complaints Argued Before The Supreme Court
Hospitals have brought before the Supreme Court their complaints over how CMS calculates billions of dollars in Medicare payments to safety net hospitals, known as disproportionate share hospital (DSH) payments. On Tuesday, oral arguments were heard, but the justices are not yet willing to reveal their hands.
Stat:
Hospitals Argue Supreme Court Case Over Billions In DSH Payments
Tuesday’s oral arguments before the Supreme Court in a case involving billions in Medicare payments to hospitals revealed a split among the justices willing to show their cards. (Bannow, 11/5)
Modern Healthcare:
What To Know About Supreme Court's Medicare DSH Case
A hospital industry challenge to how the Centers for Medicare and Medicaid Services computes Medicare disproportionate share hospital payments is up for consideration at the highest court in the land Tuesday. The Supreme Court will hear oral arguments on Advocate Christ Medical Center v. Becerra, which is the third DSH payments lawsuit the justices have considered since 2019. (Early, 11/5)
Other health industry developments —
Fierce Healthcare:
Hospital Groups Blast Senators' Site-Neutral Payment Reform Plan
Federation of American Hospitals Executive Vice President of Public Affairs Charlene MacDonald said site-neutral policies "equate to Medicare cuts that threaten access to 24/7 hospital care—a framework Congress has rejected time and again." "Seniors deserve better than tired old policies pushed by the insurance industry that just threaten access to reliable hospital care," MacDonald said. (Landi, 11/5)
Bloomberg:
UnitedHealth Unilaterally Cut Doctors' Pay For ER, Mental Health, Records Show
UnitedHealth Group Inc. systematically cut what it paid for emergency room visits and mental health care to doctors outside of its network, sparking internal tension over how those changes were handled and the potential effect on members, newly unsealed court documents show. The records open a window into the workings of its UnitedHealthcare unit, the largest US health insurer, and shed light on a bitter battle between financial heavyweights in the $5 trillion US medical system. (Tozzi, 11/5)
ABC13 Houston:
St. Joseph Medical Center Employees Say They're Missing Paychecks After Transition To New Owners, Healthcare Systems Of America
The transition to new ownership for St. Joseph Medical Center in downtown Houston isn't going very smoothly for some hospital employees, who say they didn't receive their paychecks or the correct amount that they earned. In May, Steward Health Care, who previously owned St. Joseph, filed for Chapter 11 bankruptcy. In a news release, the company wrote that one of the primary factors included "challenges created by insufficient reimbursement by government payers as a result of decreasing reimbursement rates." (Nguyen, 11/4)
Modern Healthcare:
Cerebral Avoided Paying $2.9M Fine To DOJ
Embattled digital behavioral health company Cerebral has agreed to pay the federal government more than $3.6 million in fines but will defer payments on additional charges due to the company's financial condition. The Justice Department and Drug Enforcement Administration said Monday that the company has agreed to pay the fines as part of a non-prosecution agreement with the U.S. Attorney’s Office for the Eastern District of New York. (Turner, 11/5)
Military.com:
Veterans File Class-Action Suit Over Medical Retirements For Burn Pit-Related Illnesses
Two veterans have filed a class-action lawsuit against the Army for refusing to classify illnesses linked to burn pit exposure as combat-related, a designation that would make their medical retirement pay tax-free. Retired Sgt. 1st Class Kyle Smoke and retired Lt. Col. Jennifer McIntyre filed suit Oct. 15 in the U.S. District Court in Washington, D.C., over the retirements they were awarded after being exposed to burn pits during their deployments to Iraq, and Afghanistan in McIntyre's case. (Kime, 11/5)
Military Times:
DOD Fixes Problem That Mistakenly Dropped 16K Tricare Beneficiaries
Defense officials are advising about 16,000 Tricare beneficiaries who briefly lost their Tricare eligibility last week after being inadvertently dropped from the rolls of the Defense Enrollment Eligibility Reporting System to call the DEERS Support office to confirm that they are now good to go. Officials attributed the hiccup to a data transfer. (Jowers, 11/5)
KFF Health News:
Community Health Workers Spread Across The US, Even In Rural Areas
Kelly Engebretson was excited to get fitted for a prosthetic after having part of his leg amputated. But he wasn’t sure how he’d get to the appointment. Nah Thu Thu Win’s twin sons needed vaccinations before starting kindergarten. But she speaks little English, and the boys lacked health insurance. ... Engebretson, Win, Arce, and Serrano were fortunate to have someone to help. They’re all paired with community health workers in Huron, a city of 14,000 people known for being home to the state fair and what’s billed as the world’s largest pheasant sculpture. (Zionts, 11/6)
