Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.


May 14, 2021

Around the nation: 32 hospitals sue HHS over Medicare payments

Daily Briefing

    A group of 32 hospitals located in states that did not expand Medicaid under the Affordable Care Act are suing HHS to recalculate their Medicare payments for treating a disproportionate share of low-income patients, in today's bite-sized hospital and health industry news from the District of Columbia, Florida, and Maryland.

    • District of Columbia: A group of 32 hospitals are suing HHS, arguing the agency should recalculate their Medicare payments for treating a disproportionate share of low-income patients for 2014, 2015, and 2016. The hospitals—which include Baylor University Medical Center, Regional One Health and Houston Methodist Hospital—are located in states that had not expanded Medicaid under the Affordable Care Act. They argue that, despite their states' decisions not to expand Medicaid, patients who would have been covered under Medicaid expansion should nonetheless be counted as "low-income patients" for the purpose of calculating Medicare's disproportionate share hospital payments (Gellman, Modern Healthcare, 5/12; Vaidya, MedCity News, 5/12).
    • Florida: Lee Health has named Jennifer Higgins as its CNO. Higgins had been serving as interim CNO of Lee Health and had also served as chief nurse executive at Gulf Coast Medical Center. According to Lee Health, Higgins will continue serving in her role at Gulf Coast until a replacement is named (Gooch, Becker's Hospital Review, 5/11).
    • Maryland: Gov. Larry Hogan (R) on Wednesday announced that Maryland will be lifting all statewide capacity limits effective May 15. Hogan also announced that he intends to lift the state's indoor mask mandate once 70% of residents have received at least one dose of a Covid-19 vaccine, which he expects to happen by Memorial Day weekend. Local authorities are, however, permitted to keep stricter rules in place (Wiggins et. al., Washington Post, 5/12).

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.