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

Share this article:

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)

Share this article:

More in News

Expert says providers often wrongly threatened by PEPPER reports

Instead of fearing further scrutiny by federal authorities, providers should embrace the opportunity to get feedback in the form of PEPPER reports, legal experts said Monday at the LeadingAge annual meeting in Nashville.

Healthcare reform already driving diverse, dynamic long-term care models, LeadingAge leaders say

Healthcare reform already driving diverse, dynamic long-term care ...

One way to gauge the effects is healthcare reform is by looking at ongoing changes to the continuing care retirement community model, LeadingAge officials said Monday at the association's annual ...

Experts say providers often wrongly threatened by PEPPER reports

Instead of fearing further scrutiny by federal authorities, providers should embrace the opportunity to get feedback in the form of PEPPER reports, legal experts said Monday at the LeadingAge annual meeting and exposition in Nashville.