UPMC hospital to receive $5M in new annual funds after Medicare reclassification: 4 things to know

Williamsport (Pa.) Regional Medical Center is set to receive an additional $5 million in Medicare reimbursement for fiscal years 2018 and 2019, despite losing a recent court battle, according to a report on PennLive.com.

Here are four things to know.

1. The hospital, part of Williamsport-based UPMC Susquehanna Health, has sought Medicare Geographic Classification Review Board reclassification from the State College to the Bloomsburg-Berwick core-based statistical area.

2. The MGCRB processes requests from hospitals seeking reclassification. A hospital's classification affects how much Medicare reimbursement it receives, and a classification to an area with a higher wage index can result in increased monies.

3. Officials denied Williamsport Regional's reclassification request for fiscal years 2017, 2018 and 2019. This prompted the hospital to file a lawsuit last March against HHS, CMS, the MGCRB and its representatives, contending the denial violated Administrative Procedure and Medicare acts as well as part of the 14th Amendment, according to the report. The report states the hospital ultimately wanted a court order requiring reclassification and the additional Medicare reimbursement the hospital estimated it would have received if its initial request wasn't denied.

4. U.S. Middle District Judge Matthew Brann dismissed Williamsport Regional's suit Thursday, reports PennLive.com. This means the hospital lost out on the additional Medicare reimbursement for fiscal year 2017. However, the federal government in October granted the hospital reclassification for fiscal years 2018 and 2019, which means the hospital will accrue about $5 million in estimated additional Medicare funds it would not have received under its previous classification, according to court documents cited by PennLive.com.


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