New Hampshire hospitals win lawsuit against state over Medicaid DSH payments

A U.S. District Court ruled in favor of the New Hampshire Hospital Association in a dispute over how much the state owes hospitals that serve a large number of Medicaid and uninsured patients, according to The New Hampshire Union Leader.

Here are five things to know about the ruling.

1. In a 48-page order filed March 2, U.S. District Court Judge Landya McCafferty ruled in favor of the NHHA. The association filed the case early last year on behalf of some of its members, arguing New Hampshire owed them $33 million in Disproportionate Share Hospital payments for the fiscal year ending last June.

2. The state, which is facing a budget deficit, had only allocated $191 million for DSH payments last fiscal year, though the hospitals anticipated $224 million based on a written agreement, according to the report. The DSH payments help the hospitals cover uncompensated care costs for treating a large number of Medicaid beneficiaries and uninsured patients.

3. The NHHA said in a statement to the Union Leader the "hospitals are very pleased with the ruling, which ensures that long-standing policy with respect to the calculation of uncompensated care is upheld and maintained."

4. In the order, Judge McCafferty issued a ban on using language from CMS' "frequently asked questions" section to determine DSH payments, according to the report. The FAQs section states "third-party payments" that hospitals receive from Medicare should be considered when calculating DSH payments. The judge ruled since information in the FAQs section was not made known through a "rulemaking procedure," it is unlawful to calculate DSH payments based on that information. 

5. A spokesperson for New Hampshire Gov. Chris Sununu (R) told the publication the ruling was "expected" and "though we will continue to receive clarity in the coming months, we are comfortable that the 2018-19 budget is appropriate."  

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