137 hospitals sue HHS over HSP rate adjustment
A group of 137 hospitals, mainly ones in rural areas, sued HHS to recoup about $86.6 million in Medicare payments and change future small-hospital reimbursement formulas. Medicare pays many small and rural hospitals under a special reimbursement policy called the hospital-specific payment rate, which provides higher rates than standard community hospitals receive. The HSP applies to sole community hospitals and Medicare-dependent small rural hospitals. In 2010, the HSP was adjusted downward as part of a larger effort to slow apparent growth in medical spending caused by changes in billing codes—the CMS’ “documentation and coding adjustment” process. Ankur Goel, an attorney with the hospitals’ law firm, McDermott Will & Emery in Washington, said the CMS in the past decided that it was legally not allowed to apply such coding adjustments to the rural hospitals’ HSP rate. Yet in 2010, the agency changed its mind and applied the change, he said. “We don’t think CMS has the authority to adjust the rates in the way that they did under the Medicare statute,” Goel said. CMS officials declined to comment on the lawsuit, which was filed in U.S. District Court in Washington. be replaced in the interim by Doug Howell, a consultant to the system, according to a statement by Jewish Hospital & St. Mary’s that was read by a spokeswoman. Jewish Hospital & St. Mary’s HealthCare, affiliated with Catholic Health Initiatives, Englewood, Colo., is in the middle of a proposed $620 million three-way merger with the University of Louisville (Ky.) Hospital and St. Joseph Health System Lexington, Ky., another CHI-affiliated organization. Bonick was a
Modern Healthcare Up & Comer in 2008, the year he joined Jewish Hospital. “We appreciate his tenure with the organization and the contributions he has made during that time,” the system said in the statement.