U.S. Supreme Court justices weighed whether hospitals and other health-care providers have the right to challenge Medicaid reimbursement rates set by states. <\/p>\n
A group of health-care providers argued in an Idaho case Tuesday that the U.S. Constitution allows them to contest their reimbursements under the Medicaid health-insurance program for the poor. The position is backed by hospitals, which say that the low rates arent covering their costs. <\/p>\n
Chief Justice John Roberts asked during arguments in Washington whether allowing such lawsuits from hospitals and health-care providers would put state budgetary decisions in the hands of federal judges. <\/p>\n
The effect here is that federal judges get to decide what the reimbursement rates are in a particular area, Roberts said. Are you aware of any situation where the federal judges get together and try to balance the state budget? <\/p>\n
Medicaid is jointly funded by the federal and state governments and administered by the states under federal requirements. The case pits states against hospitals and health-care providers, which want the right to challenge their reimbursements. A federal appeals court ruled against Idaho and said the health-care providers could sue. <\/p>\n
Four justices said in a dissenting opinion in a separate 2012 case from California that health-care providers didnt have a right to sue over reimbursement rates. <\/p>\n
During arguments, Justice Sonia Sotomayor pressed Idahos lawyer about what recourse providers have. <\/p>\n
Lets assume, as inflation is going up constantly, what happens two years into the plan when providers cant work for what the state is giving, or the state is imposing a tremendous hardship on them, which is happening to a lot of providers who are being underpaid, she said. Where do they go? <\/p>\n
The dispute stems from reimbursement rates set by Idaho for services provided to people with developmental disabilities. Health-care providers sued the state, claiming the reimbursement rates were too low to comply with the federal Medicaid law. A federal court agreed and said the rates were unlawful because the state didnt consider provider costs. <\/p>\n
The American Hospital Association and the Federation of American Hospitals, in a court brief supporting the Idaho health-care providers, said the cost of providing care to Medicaid beneficiaries in 2012 exceeded reimbursements by $13.7 billion. <\/p>\n
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Health-Care Providers Challenge Medicaid Rates at High Court<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" U.S. Supreme Court justices weighed whether hospitals and other health-care providers have the right to challenge Medicaid reimbursement rates set by states. Continue reading