Tag Archives: 10-5163

D.C. Circuit Rejects HHS’s Retroactive Application of New Medicare Reimbursement Policy

Northeast Hospital Corp. v. Sebelius, No. 10-5163 (Sept. 13, 2011) (Griffith, J., joined by Garland, J., with concurrence in the judgment by Kavanaugh, J.)

In this case, the D.C. Circuit affirms summary judgment in favor of a hospital that was undercompensated by Medicare. Although the majority concludes the statutory formula for calculating a hospital’s “disproportionate share hospital” (“DSH”) adjustment is ambiguous as to how Medicare Part C enrollees should be counted, all three members of the panel agree HHS’s application of a new statutory interpretation was impermissibly retroactive. The case raises questions about the direction of the Court’s retroactivity doctrine. Continue reading