Nov 22, 2019

Hospitals are suing HHS over Medicare payments

Illustration: Sarah Grillo/Axios

Hundreds of hospitals are suing the Department of Health and Human Services, claiming in a pair of lawsuits that they've been shortchanged on Medicare payments.

Why it matters: Medicare is full of highly technical payment policies that change every year, and hospitals are trying to recoup billions of taxpayer dollars in these cases.

Details: Both lawsuits were filed this week.

  • Lawsuit #1: A group of more than 600 hospitals argued HHS illegally allowed a 0.7% cut to inpatient services to continue in 2018 and 2019 when it should've stopped, by law, in 2017. They said the cuts cost the industry $840 million, and they want that money back, plus interest.
  • Lawsuit #2: Dozens of hospitals are saying HHS is not abiding by a recent Supreme Court decision that said the federal government was incorrectly calculating supplemental Medicare payments that help hospitals that treat larger numbers of low-income patients. Hospitals contend they are owed at least $4 billion in underpayments.

Between the lines: Hospitals have not been shy lately to use the courts as a vehicle to halt payment policies they believe are unlawful.

  • But most hospital systems, which have consolidated heavily over the years, have remained financially strong despite these cuts and alleged underpayments.

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Hospitals are going to war against Trump's price transparency push

Illustration: Lazaro Gamio/Axios

Hospitals sued the Trump administration yesterday over its requirement that they disclose their negotiated rates, the latest of the industry's moves to protect itself from policy changes that could hurt its revenues.

Why it matters: Hospitals account for the largest portion of U.S. health costs — which patients are finding increasingly unaffordable.

Go deeperArrowDec 5, 2019

Hospitals win back $800 million from Medicare

Illustration: Sarah Grillo/Axios

The Trump administration is backtracking on a major policy that cut payments to hospitals while the policy is stuck in the courts.

The big picture: The hospital industry is getting back almost $800 million, and the Trump administration has failed to implement another regulation — one that most experts support, too.

Go deeperArrowDec 13, 2019

Hospitals sue Trump administration over price transparency rule

Hospitals are taking the price transparency rule to court. Photo: RJ Sangosti/The Denver Post via Getty Images

A consortium of hospitals has filed a lawsuit against the Trump administration, arguing that a new rule — which will require hospitals in 2021 to publicly post prices that are negotiated with health insurers — is unconstitutional and unlawful federal overreach.

Why it matters: This lawsuit was expected, but solidifies how the hospital industry is opposed to any regulation that would force them to reveal confidential prices.