Hospitals win back $666M from Medicare

Thu, 13 Mar 2008 07:59:58 -0400

In a deal that marks one of the largest settlements ever paid by the federal government to healthcare providers, CMS has agreed to pay out $666 million to 667 hospitals that sued for back payments. The dispute dates back to shifts in Medicare reimbursement policies from the 1980s. In 1986, the Reagan administration changed reimbursement rules to exclude some low-income patients from disproportionate-share payment calculations. A number of hospitals sued to have the rule changed, and succeeded in 1997. Following the reversal, one hospital sued for back payments for treatment in the 1990s, and eventually attracted a total of 667 hospitals seeking reimbursement as well--most of which were nonprofits treating largely the poor. The hospitals won in federal court, and the federal government lost its appeal, then got rejected for a hearing by the Supreme Court.

To learn more about the case:
- read this piece from The Wall Street Journal (sub. req.)
- read this Modern Healthcare article (reg. req.)

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