Why 131 Hospitals Are Suing HHS Over Alleged Underpayment

Katie Adams / medcitynews - A group of 131 hospitals has sued HHS over a CMS policy they say improperly reduces Medicare disproportionate share hospital (DSH) payments. The lawsuit is the latest in a decade-long legal battle over how the agency counts patient days and calculates pay…

AI Summary: One hundred thirty‑one hospitals have filed suit challenging HHS’s 2023 Disproportionate Share Hospital calculation, arguing the agency’s formula undercounts uncompensated care and systematically underpays safety‑net providers. The plaintiffs seek to overturn the rule and recover alleged shortfalls, warning that ongoing underpayment threatens hospital finances and patient access.

CMS finalizes Medicare Advantage star ratings overhaul, sending billions of dollars more to insurers

Rebecca Pifer Parduhn / healthcaredive - Regulators cut almost a dozen metrics that factor into the quality ratings and reverted back to an older and more generous bonus system. MA plans will get more than $18 billion in additional payments over the next decade as a result.

AI Summary: The Centers for Medicare & Medicaid Services locked in a sweeping overhaul of Medicare Advantage star ratings that will shift billions of dollars in payments and alter plan incentives. The ruling adjusts rating calculations and enrollment provisions, prompting industry and provider concerns about downstream effects on access, plan behavior, and provider-network stability.