In Becerra v. Empire Health Foundation the U.S. Supreme Court held 5-4 that patients whom Medicare insures but does not pay for on a given day are counted in the Medicare fraction for purposes of computing a hospital’s disproportionate-patient percentage.
Continue readingU.S. Supreme Court Allows Health Plans to Disfavor Uniform Dialysis Benefits
In Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita the U.S. Supreme Court held 7-2 that group health plans which offer all participants the same limited outpatient dialysis benefits don’t violate the Medicare Secondary Payer statute.
Continue readingSCOTUS Decides Billion Dollar Medicare Drug Reimbursement Case
In American Hospital Association v. Becerra the U.S. Supreme Court held unanimously that if Health and Human Services (HHS) wants to reimburse Section 340B hospitals for certain outpatient prescription drugs provided to Medicare patients at a different rate than other hospitals it must conduct a survey of hospitals’ drug acquisition costs.
Continue readingSupreme Court to Decide Medicare Dialysis Case
In this case the Court will decide whether private health insurance plans may treat dialysis coverage less favorably than other plan benefits.
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.
Continue readingSupreme Court to Review Application of Hospital Medicare Drug Reimbursement Statute
In American Hospital Association v. Becerra the U.S. Supreme Court will decide whether Health and Human Services (HHS) may set the reimbursement rates for drugs the covered by Medicare based on acquisition cost and vary such rates by hospital type if HHS has not collected hospital acquisition cost data.
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