Becker's Hospital Review

24 CFO / FINANCE HHS asks Supreme Court to review Medicare payments ruling: 7 things to know By Kelly Gooch H HS is calling on the U.S. Supreme Court to review a District of Colum- bia appeals court ruling that CMS act- ed improperly when it altered its methods for calculating uncompensated care reimburse- ments six years ago, according to Law360. Here are seven things to know. 1. e United States Court of Appeals for the District of Columbia Circuit issued the ruling in July 2017. 2. HHS filed a petition asking the U.S. Su- preme Court to review the appeals court deci- sion. HHS stated that the July ruling conflicts with other appeals courts decisions. ose decisions found CMS' changes to Medicare reimbursements do not have to conduct no- tice-and-comment rulemaking, according to Law360. e petition states: "e decisions of other courts of appeals reflect the view that instructions from HHS to its Medicare Ad- ministrative Contractors, [which act on be- half of the agency] about Medicare fractions lack the force and effect of law, and thus do not qualify as a 'substantive legal standard'" with regards to Medicare reimbursement. 3. e petition to the U.S. Supreme Court comes roughly four months aer the D.C. Circuit Court declined to reconsider its pre- vious ruling, according to Law360. 4. HHS stated in its petition: "e court of ap- peals' decision threatens to undermine HHS' ability to administer the Medicare program in a workable manner." 5. In 2014, a group of hospitals filed a lawsuit over CMS' move to include Part C enrollees with Part A enrollees when calculating dis- proportionate share hospital payments, which reimburses hospitals for care delivered to in- digent patients. e move resulted in lower payments to hospitals, according to Law360. e lawsuit sought to push CMS to recalculate the DSH formula without Plan C enrollees. 6. HHS is calling on the U.S. Supreme Court to take another look at the appeals court de- cision because the agency contends it "creates a circuit split by holding that Section 1395hh's notice-and-comment procedures apply to in- terpretive rules." e agency argues the D.C. court's decision undermines the agency's abil- ity to conduct its reimbursement program. 7. CMS no longer groups patients with Part C Medicare plans with Part A enrollees for those reimbursement purposes, according to the report. n Presbyterian Healthcare Services' net income nearly doubles By Kelly Gooch A lbuquerque, N.M.-based Presbyterian Healthcare Services saw revenues decrease in 2017, but ended the year with a significant increase in net income, according to bondholder documents. The eight-hospital system reported revenues of $3.12 bil- lion in 2017, down from revenues of $3.14 billion the year prior. The decrease was at least partially due to a decline in net premiums. The system's net patient service revenue climbed from $1.02 billion to $1.07 billion year over year. At the same time, Presbyterian saw expenses grow 0.5 percent in 2017 compared to 2016, which is attributable to increased supply costs, increased spending on sala- ries, wages and employee benefits, and increased pro- fessional fees. With expenses factored in, Presbyterian ended 2017 with operating income of $48.6 million, compared to $74.9 mil- lion in 2016. Gains from nonoperating income, including investment income, spurred the system's significant increase in net in- come. Presbyterian ended 2017 with net income of $300.7 million, up from $157.4 million the year prior. n Texas hospital locks in 5-year deal with consulting firm after UHS backs out By Kelly Gooch C ommunity Hospital Consulting, part of Plano, Tex- as-based Community Hospital Corp., began operating North Texas Medical Center in Gainesville. NTMC, a 60-bed facility owned by the Gainesville Hospi- tal District, started looking for a new management com- pany after King of Prussia, Pa.-based Universal Health Services cancelled its management agreement with the distressed hospital. NTMC entered a five-year management agreement with Community Hospital Consulting, effective May 1. "We are excited to bring CHC's expertise in hospital man- agement and talent in critical areas such as the revenue cycle and supply chain to strengthen NTMC," said CHC President and CEO Jim Kendrick, in an April 10 release. "CHC's mission to guide, support and enhance the mission of community hospitals and healthcare providers aligns with NTMC and its mission to serve residents of Cooke County with quality healthcare for years to come." CHC Consulting said UHS will still "continue to collaborate as a tertiary partner in the region," according to the release. n

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