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CMS Appeals Missouri Ruling on Medicaid DSH Payments

By Steven Porter  
   April 13, 2018

The original lawsuit was filed by the Missouri Hospital Association regarding how DSH payments are calculated.

The Centers for Medicare and Medicaid Services (CMS) filed an appeal Friday of a federal court decision that had blocked it from enforcing a final rule last year regarding disproportionate share hospital (DSH) payments.

The move challenges a win by the Missouri Hospital Association (MHA), which was granted summary judgment in February after filing the original lawsuit in March 2017.

The MHA argued that a frequently asked questions (FAQs) page and final rule prepared by CMS contradicted the Medicaid Act. District Court Judge Brian C. Wimes agreed and blocked CMS from enforcing either document.


Related: Federal Judge's Ruling Could Block Lower DSH Payments to Hospitals


Jane Drummond, MHA general counsel, told HealthLeaders Media in February that she expected the Missouri ruling would be appealed.

"We are one of three cases that have challenged the Final Rule and this is the first decision invalidating it, so they will most certainly appeal to preserve their position in those other two cases," Drummond said.

At issue is the formula used to calculate DSH payments. If the MHA ultimately prevails, hospitals would potentially be spared from hundreds of millions of dollars in recoupment.

Steven Porter is editor at HealthLeaders.

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