In 2016, CMS required Medicaid repayment from two Chicago-based safety-net hospitals: $140.3 million from the University of Illinois Hospital and $4.5 million from Mount Sinai Hospital.
The federal government paid the two hospitals $377.3 million in Disproportionate Share Hospital allotments — given to hospitals that treat a disproportionate share of low-income patients — from July 1996 through June 2000.
Central to Illinois’ argument is that the payments should have been calculated through a prospective method. CMS has disagreed with Illinois, using a retrospective method.
In April 2018, HHS’ Departmental Appeals Board sustained CMS’ 2016 repayment requirement. “We conclude that the process that Illinois used to calculate and apply the hospital-specific DSH limits did not follow the standards and methodologies in Illinois’ Medicaid State plan,” the board said.
More articles on legal and regulatory issues:
DOJ supports striking entire ACA: 5 things to know
8 latest healthcare industry lawsuits, settlements
MedStar will pay $35M to settle kickback allegations
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
