More than 400 hospitals have reached undisclosed settlements with the federal government over challenges to methods HHS uses to calculate disproportionate-share hospital payments.
Among the hospitals and systems are Catholic Health Initiatives, Beth Israel Deaconess Medical Center and St. Elizabeth's Medical Center, both in Boston, and UMass Memorial Health Care in central Massachusetts, among others.
Four of the five plaintiff hospital groups have settled their claims with HHS over its DSH calculations, which covered tens of millions of dollars in disputed reimbursements, according to court documents.
Some of the hospitals have refused to settle their allegations, either entirely or for specific cost years, court documents showed.
No settlement terms or amounts have been disclosed, other than each party will pay their own costs and attorney's fees.
The underlying litigation started in 2010, when dozens of hospitals asked a D.C. federal court to review DSH payments owed to them for fiscal years 1992 through 2004, claiming HHS had wrongfully reduced the payments by improperly categorizing Medicare and Medicaid patient days in the calculation.
The hospitals maintained that HHS repeatedly categorized dual-eligible patients as eligible for Medicare—rather than Medicaid—benefits even after their coverage had been exhausted, which dropped their low-income patient rate and led to lower DSH payments.
U.S. District Judge Ellen Huvelle agreed to give the final group of hospitals additional time to negotiate a settlement before moving forward with the litigation, extending deadlines for further briefing until November or later.
According to legal news site Law360, the settlements cover approximately 430 hospitals and 1,700 cost years of DSH reimbursement payments, averaging out to about four cost years per hospital.
Counsel and representatives for the hospitals and the federal government did not respond to requests for comment Friday.
