Six Massachusetts hospitals are suing the state over Medicaid reimbursement that they say has been too low and calculated in a way that contradicts state law.
The hospitals all qualify as what Massachusetts defines as carrying a disproportionate share of providing care for the poor: at least 63% of their gross patient revenue comes from Medicare, Medicaid and other government programs. In a lawsuit filed in Suffolk County Superior Court in Boston against the secretary of the Executive Office of Health and Human Services, they argue the state has calculated reimbursement primarily as a percentage of a statewide average cost of care at all hospitals, violating a statutory requirement to pay disproportionate-share hospitals “based on their actual financial needs.”
A spokesman for the office said in a written statement that the state recently upped the payments to disproportionate-share hospitals by 10% in recognition of the important role they play. “While we cannot comment on the lawsuit itself, we are confident that the state's actions comply with all applicable law and will be upheld,” spokesman Juan Martinez said in the statement.
The plaintiffs are 179-bed Holyoke (Mass.) Medical Center; 283-bed Berkshire Medical Center, Pittsfield; 130-bed Quincy (Mass.) Medical Center; 90-bed Merrimack Valley Hospital, Haverhill; 243-bed Cape Cod Hospital, Hyannis; and 224-bed Signature Healthcare Brockton (Mass.) Hospital.
Each of the hospitals says it was deprived of several millions of dollars over the past six years as a result of the challenged methodology.