U.S. district court invalidates federal calculation for hospice care reimbursement

The U.S. District Court for the Western District of Oklahoma recently ruled that a federal regulation capping Medicare payments for hospice care providers is invalid. That echoes a Texas district court ruling handed down earlier this year.

The regulation in question deals with how Medicare beneficiaries receiving hospice care are counted and how providers are reimbursed. The calculation method employed by the Department of Health and Human Services counts a beneficiary only once during a single fiscal year, regardless of whether that beneficiary has received treatment over multiple fiscal years. The Oklahoma court sided with Compassionate Care Hospice in its decision, which says HHS' calculation method fails to follow the congressional mandate governing hospice reimbursements, the Bureau of National Affairs reports.

The case is one of a number of similar cases working their way through the U.S. legal system. In February, the U.S. District Court for the Northern District of Texas reached a similar conclusion in the case of Lion Health Services Inc v. Sebelius. (McKnight's, 3/4/10)