South Carolina hospital denied Medicare payment

A district court on Jan. 18 affirmed HHS’ decision to deny Lancaster (S.C.) Hospital Corp. Medicare reimbursement for 1997 because it failed to submit information supporting the payment request, according to Bloomberg

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Four things to know:

1. Lancaster, formerly Springs Memorial Hospital, operates an inpatient rehabilitation facility that provides services for Medicare beneficiaries.

2. As a participant in the Medicare program, Lancaster was responsible for familiarizing itself with the legal requirements for reimbursement, including the need to provide data to verify that its payment request reflected costs incurred from treating Medicare patients, according to the court opinion posted on Justia

3. The hospital group argued that — even if some reductions were warranted — HHS should not have denied its entire reimbursement request for the fiscal year. 

4. While it may seem harsh to deny Lancaster reimbursement for the entire year, the principle that people “must turn square corners when they deal with the government” “has its greatest force when a private party seeks to spend the government’s money,” the court stated.

Click here to read the court opinion.

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