In 2010, the federal Medicare payer decided to adjust the HSP downward as part of a larger effort to slow the apparent growth medical spending that was coming for changes in billing codes—the CMS’ “documentation and coding adjustment” process.
Ankur Goel, an attorney with the hospitals’ law firm, McDermott Will & Emery in Washington, said the CMS had in the past decided that it was legally not allowed to apply such coding adjustments to the rural hospitals’ HSP rate. Yet in 2010, the agency changed its mind and applied the change, he said.
“We don’t think CMS has the authority to adjust the rates in the way that they did under the Medicare statute,” Goel said. “CMS reached that same conclusion several times over the past few years, and we agree with their prior determinations on that.”
The lawsuit seeks to recoup all the money not paid under the adjustment, and to reverse the change in the future though a judicial finding that the CMS can’t legally apply the coding adjustment to the HSP.
CMS officials declined to comment, citing department policy of not commenting on pending litigation.
The lawsuit was filed Thursday morning in U.S. District Court in Washington.