Disproportionate-Share Hospital Program

In a unanimous decision, the Supreme Court has affirmed the U.S. Department of Health and Human Services’ authority to refuse extensions for Medicare disproportionate-share reimbursement appeals beyond the usual 180-day deadline or three years “for good cause.”  The decision was in response to a lawsuit filed by 18 hospitals that challenged their Medicare disproportionate-share adjustments for 1987 through 1994. The challenge arose after the Provider Reimbursement Review Board found, in 2006, that errors in the Centers for Medicare & Medicaid Services’ methodology resulted in a systematic under-calculation of the disproportionate-share adjustment and corresponding underpayments to providers. The court’s decision is available at www.supremecourt.gov/opinions/12pdf/11-1231_32q3.pdf.