Supreme Court sides with HHS on hospital payment formula

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2 Min Read

Tara Bannow , 2025-04-29 20:53:00

Tara Bannow covers hospitals, providers, and insurers. You can reach Tara on Signal at tarabannow.70.

The Supreme Court on Tuesday rejected hospitals’ argument that the federal government doesn’t pay them enough for treating low-income patients.

The seven-justice majority instead sided with the Department of Health and Human Services’ interpretation of the law concerning disproportionate share hospital, or DSH, payments, which compensate hospitals for treating low-income patients. More than 200 hospitals brought the case, Advocate Christ Medical Center v. Kennedy, arguing the federal agency’s misreading of the law causes it to underpay them by well over $1 billion each year. 

At the heart of the case is how DSH payment amounts are calculated, and specifically, which patients count toward that total. A hospital’s DSH payment consists of its Medicaid and Medicare fractions. The Medicare portion is calculated using the number of patient days attributed to people on Medicare who are also entitled to supplemental security income, or SSI benefits. 

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