A 13-year Medicare payment dispute over a formula for calculating supplemental reimbursements will head back to HHS to be reevaluated, The U.S. District Court for the District of Columbia ruled Feb. 8.
The legal dispute between Empire Health Foundation and HHS first began in 2009. Empire Health Foundation sued HHS, arguing that a change in the formula used by the department to calculate disproportionate share hospital payments caused it to lose out on reimbursement it was owed.
Specifically, the lawsuit takes issue with a Medicare policy change that included a new methodology for allocating Medicare Part C days in the disproportionate share hospital formula.
The court ruled that sending the case back to HHS is the "most efficient course" for resolving the case, in light of a forthcoming rule from the agency addressing the calculation in question.