Appeals court reverses decision voiding CMS rule on Medicaid DSH audits
The U.S. Court of Appeals for the District of Columbia Circuit yesterday a district court decision that voided a 2017 Centers for Medicare & Medicaid Services rule that included Medicare and private insurance payments when calculating the hospital-specific limit on Medicaid disproportionate share hospital payments. In a case brought by 12 not-for-profit children鈥檚 hospitals in Texas, Minnesota, Virginia and Washington, D.C., the district court last year ruled the regulation contrary to the plain language of the Medicaid Act and 鈥渁rbitrary and capricious鈥 under the Administrative Procedures Act. The appeals court disagreed, reinstating the 2017 rule. The AHA had urged CMS and Congress to withdraw the rule, voicing support for the hospitals鈥 arguments and significant concerns about the rule鈥檚 impact on Medicaid DSH hospitals.