Hospital wins lawsuit
Hospital wins lawsuit
Delays by the U.S. Department of Health and Human Services (HHS) in implementing regulations for reimbursement of medical education costs could be a boon to some hospitals.
The 6th U.S. Circuit Court of Appeals in Cincinnati has ruled against an HHS attempt to reclaim money it maintains was overpaid to the Toledo (OH) Hospital.
The disagreement stems from a 1986 federal policy that pays hospitals for Medicare’s share of medical education, based on a hospital’s 1984 audited costs. However, the government did not issue regulations for the rule until 1989, and some fiscal intermediaries did not do the reauditing until 1991. Toledo Hospital challenged the government’s right to retroactively take the money, claiming that the HHS violated its time constraints for a reaudit. The appeals court agreed.
According to one estimate, $200 million in reimbursements from hospitals is at stake. Other hospitals also have contested the government’s attempt to take back funds, and the issue is expected to be taken to the U.S. Supreme Court.
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