News By/Courtesy: Lia Jils | 03 Oct 2020 9:19am IST


  • The fate of children's hospital are in a poor state.
  • The Medicaid payments are less than the cost of caring for those patients.
  • Chevron Deference.

The fate of children's hospitals is in a poor state. The U.S. Supreme court challenges the formula used by federal regulators to compensate hospitals serving the needs of poor patients. The Children's Hospital Association asked the high court to decide by upholding federal rule that would reduce payments to hospitals for the uncompensated care they receive from medical and private insurance. The 2017 rule violated the Medicaid statute and will cost a large amount per year which leads to a reduction in health-care services offered to low-income patients. This rule is mainly affecting the children's hospital and many others too if it's not overturned. This will cost millions of dollars that will undermine the congress's goals of ensuring specialized care to children.

The Department Of Health asks the question of how to define the cost uncompensated care. The 2017 rule is related to Congress's purpose of directing payments to hospitals most in need. The problems deferred to HHS in interpreting the Medicaid Statute are also challenging. The Supreme Court considered the petition for review at its Sept.29 conference. The Medicaid payments to hospitals are less than the cost of caring for those patients. The Disproportionate Share Hospital Payments are made to help or reduce the gap between payments and cost care. But the Medicaid Statute doesn't address other sources of payments to the Medicaid-eligible patients some of them are covered by Medicare or private insurance. Under the rules, the state will deduct payments to hospitals from those other sources when calculating the amount of DSH payments the hospitals will get. Around 12.3 billion dollars were allocated to the states for DSH payments. The 2017 rule won't affect the total amount of DSH funds allocated to safety-net hospitals according to the 2019 report. But the rule can cut the number of funds reaching the hospitals by reducing the amount they qualify. This change can also lead to the redistribution of funds among various hospitals.

 Children's hospitals treat patients who relatively have private insurance, some of them may be qualified for Medicaid, such as low-birth-weight babies, etc. The private insurance payments for those patients will eliminate the chance for hospitals to qualify for DSH payments. The 2017 rule represented a change in the HHS interpretation that was not entitled to the Chevron deference. They argue that the Medicaid Statute did not grant HHS the authority to redefine costs. The court should cut Chevron the political body said.



This article does not intend to hurt the sentiments of any individual, community, sect, or religion, etcetera. This article is based purely on the author’s personal opinion and views in the exercise of the Fundamental Rights guaranteed under Article 19(1)(A) and other related laws being enforced in India for the time being.

Section Editor: Pushpit Singh | 03 Oct 2020 10:47am IST

Tags : #health law #children

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