SCOTUS Takes on Medicare Pay Supplement for Poor Patients


July 2, 2021 7:43 pm

The U.S. Supreme Court Friday announced it will review a decision vacating a 2005 rule that changed how HHS calculates supplemental Medicare payments for hospitals that serve a high number of poor patients.

At issue is a decision by the U.S. Court of Appeals for the Ninth Circuit, which said that the U.S. Health and Human Services Department violated the Medicare Act when it changed how it treats patients who are eligible for both Medicare and Medicaid when determining hospitals’ Medicare disproportionate share hospital payments.

The ruling gave the provider, Empire Health Foundation, a chance to recover some of the higher costs its Valley Hospital Medical Center incurred in treating patients known as “dual-eligibles,” which were reduced as a result of the rule.

HHS Secretary Xavier Becerra argued that review was required because there is a circuit split on the issue. 

King & Spalding LLP represents Empire Health. The U.S. Department of Justice represents HHS.

The case is Becerra v. Empire Health Found., U.S., No. 20-1312, review granted 7/2/21.