A growing number of hospitals are working to bolster providers’ legal fight to increase Medicare reimbursement for treating low-income patients.
Nearly 150 hospitals filed three lawsuits last week alleging the Health and Human Services Department's Provider Reimbursement Review Board wrongfully denied appeals to boost Medicare disproportionate share hospital payments, which are meant to support providers that treat many low-income patients. The complaints, which represent hospitals in more than 25 states, are similar to ongoing lawsuits representing hundreds of other providers looking to overturn review board denials due to alleged DSH miscalculations.
Related: How hospitals are fighting for higher DSH payments
HHS did not immediately reply to a request for comment.
Hospitals contend the Centers for Medicare and Medicaid Services should include all Medicare, Medicare Advantage and Social Security Supplemental Security Income beneficiaries when figuring how much DSH-eligible providers should get paid. However, CMS determines DSH funding based on the number of fee-for-service Medicare patients who received SSI cash assistance during hospital stays — a method that is alleged to deprive hospitals of billions of dollars in revenue.
