ealth and Hospital Corp. of Marion County, Indiana v. Talevski the State and Local Legal Center (SLLC) has asked the U.S. Supreme Court to hold that private parties can’t bring lawsuits for money damages under Spending Clause legislation unless the statute explicit states such suits are possible.
Continue readingSCOTUS Allows States to Recover Settlements for Future Medical Care to Reimburse Medicaid
States participating in Medicaid must require Medicaid beneficiaries to assign the state “any rights . . . to payment for medical care from any third party.” In Gallardo v. Marstiller the U.S. Supreme Court held 7-2 that states may collect from third party tortfeasors settlements allocated for the cost of future (not only past) medical care.
Continue readingSupreme Court to Decide Significant Spending Clause Case
In Health and Hospital Corp. of Marion County, Indiana v. Talevski the U.S. Supreme may decide two questions. First, it may review its holding that Spending Clause legislation allows private parties to bring lawsuits for money damages under 42 U.S.C. § 1983 (Section 1983). Assuming the Court doesn’t overturn this holding it will decide whether such claims may be brought under the Federal Nursing Home Amendments Act (FNHRA) transfer and medication rules.
Continue readingSCOTUS Red Lights Vaccine-or-Test Rule and Green Lights Vaccine in Medicare/Medicaid Facilities Rule
The Supreme Court opinions disallow the vaccine-or-test rule and allow the health care facility rule to go into effect temporarily while litigation continues over these issues in the lower courts.
Continue readingSLLC Files Supreme Court Brief in Medicaid Cost-Recovery Case
In Gallardo v. Marstiller the U.S. Supreme Court will decide whether the federal Medicaid Act allows a state Medicaid program to recover reimbursement for Medicaid’s payment of a beneficiary’s past medical expenses by taking funds from the beneficiary’s tort recovery that compensate for future medical expenses.
Continue readingSCOTUS to Decide if State Medicaid may Recover Future Medical Expense Settlements (to Pay for Past Costs)
In Gallardo v. Marstiller the U.S. Supreme Court will decide whether the federal Medicaid Act allows a state Medicaid program to recover reimbursement for Medicaid’s payment of a beneficiary’s past medical expenses by taking funds from the beneficiary’s tort recovery that compensate for future medical expenses.
Continue readingSCOTUS to Decide Hospital Stay Medicare Reimbursement Case
The issue in Becerra v. Empire Health Foundation is whether for calculating the disproportionate share hospital payment, Health and Human Services (HHS) may include in the Medicare fraction all of the hospital’s patient days of individuals who qualify for Medicare Part A benefits, regardless of whether Medicare actually paid the hospital for those particular days.
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