HHS owes tens of millions in adjusted Medicare DHS funds to hospitals: lawsuit

The federal authorities owes tens of tens of millions of {dollars} to dozens of safety-net hospitals for alleged delays in correcting  Medicare disproportionate share hospital funds, hospitals alleged in a brand new lawsuit.

Almost 4 dozen hospitals in California, Arizona, Nevada, Hawaii and Minnesota filed the go well with Tuesday in opposition to the Well being and Human Providers Division Secretary Xavier Becerra in a Washington, D.C., federal court docket. Whereas regulators conceded in 2010 the DSH fee calculations have been incorrect, HHS has delayed the amended funds, the hospitals allege.

“The company’s unreasonable delay has price the plaintiff hospitals tens of tens of millions of {dollars} in funds that ought to have been paid to them a few years in the past for the upper prices that they incurred to deal with low-income sufferers greater than a decade in the past,” the criticism alleges. 

HHS didn’t instantly reply to a request for remark.

DSH funds are supposed to offset the prices incurred by hospitals that largely serve low-income sufferers. Following a Washington, D.C., federal court docket’s 2008 ruling that affirmed a Massachusetts hospital’s problem of the DSH fee methodology, HHS was required to ship DSH fee appeals to the company’s contractors, who have been tasked with making the hospitals complete. 

However the company’s contractors haven’t made these fee redetermination calculations nor paid any of the hospitals, the criticism alleges.

The hospitals’ lawsuit alleges HHS has unjustly used a associated go well with as justification for delaying the amended funds. Minneapolis-based Allina Well being Providers filed a lawsuit in 2010 in opposition to HHS, centered on utilizing Medicare Benefit sufferers in DSH fee calculations and the associated rulemaking efforts. In 2019, the Supreme Court docket dominated in favor of hospitals, ordering HHS to vacate the regulation and carry out a extra thorough notice-and-comment rulemaking course of.

In keeping with the criticism, the Facilities for Medicare and Medicaid Providers mentioned it has not accomplished the suitable public notification course of and thus has needed to delay the amended funds.