Issue link: https://beckershealthcare.uberflip.com/i/549045
33 33 33 In the News 7 Hospitals, Health Systems Sue Feds Over Disproportionate Share Payments By Ayla Ellison S even hospitals and health systems in North Carolina have sued the federal government claiming they should have re- ceived additional disproportionate share payments last year, according to a Triad Business Journal report. Greensboro, N.C.-based Cone Health is one of the hospitals suing the federal government. e system claims it should have received $2.2 million more last year from CMS under the disproportionate share formula. Based on the assumption of increased health coverage, the Pa- tient Protection Affordable Care Act reduced disproportionate share hospital payments. The PPACA reduces DSH payments by 75 percent, or $49.9 billion, by 2019. In addition, under the PPACA, disproportionate share payments are tied to each hospi- tal's share of uncompensated care as it relates to a national pool of hospitals, according to the report. "Because of the vague and general draing of legislation, and the ACA in particular, CMS is given discretion over a lot of technical calculations that can have a large impact on provider payments," Cone Health said in a statement about the lawsuit, according to the report. "As we understand it, CMS' goal is to interpret these calculations in a way that minimizes Medicare outlays. is means that healthcare systems, as a routine matter, challenge these inter- pretations to ensure transparency, rigor and a collective provider voice in these determinations. And the vehicle to do this is typi- cally group appeals such as this." e following North Carolina healthcare organizations joined Cone Health in challenging the payments: Charlotte-based Caroli- nas HealthCare System, Wilkesboro-based Wilkes Regional Medi- cal Center, Kings Mountain (N.C.) Hospital, Laurinburg-based Scotland Memorial Hospital, Albemarle-based Stanly Regional Medical Center and Shelby-based Cleveland Regional Medical Center. n Regulators: St. Luke's is Violating Court Order by Not Unwinding Saltzer Deal By Ayla Ellison T he Federal Trade Commission and the Idaho Attorney General's Office have filed court documents claiming Boise, Idaho-based St. Luke's Health System is not complying with an order requiring it to unwind its acquisition of Saltzer Medical Group in Nampa, Idaho, according to an Idaho Statesman report. St. Luke's 2012 acquisition of the medical group was challenged by the FTC, and in January 2014, a federal judge ordered St. Luke's to reverse its acquisition of Saltzer. Two of St. Luke's competitors, Saint Alphon- sus Health System and Treasure Valley Hospital, both in Boise, and the Idaho attorney general were also plaintiffs in the case. In February, the Ninth Circuit Court of Appeals upheld the federal judge's ruling. However, it appears St. Luke's isn't complying with the court order, as the FTC and the Idaho Attorney General's Office said they are being told that St. Luke's will "divest only a fraction of the original Saltzer practice," according to the report. "We have been provided limited information…and have heard rumors and hearsay about Saltzer's current and contemplated future status," wrote the FTC and the attorney general's office in a recent court filing. "What we have been told, however, is disturbing." e issue of separating services appears to be keeping the deal from being reversed. "We were ordered to divest completely," St. Luke's general counsel Christy Neuhoff told the Idaho Statesman. However, Saltzer was "not ordered to take everything back." erefore, there is confusion as to what to do with the services Saltzer is no longer interested in. "It's one thing to say these two parties cannot be one going forward, but it's an- other for either a court or a government agency to actually dictate how a private entity runs its business going forward," Ms. Neuhoff told the Idaho Statesman. e FTC and the Idaho Attorney General's Office claim both St. Luke's and Saltzer are not being cooperative in providing information about their plans, their staffing and their finances. Ms. Neuhoff claims it is only Saltzer that is not cooperating. Saltzer President John Kaiser, MD, told the Idaho Statesman "Saltzer has been working on its divesture plan for over a year." However, he did not provide any details about the plan. n BECKER'S HOSPITAL REVIEW CEO ROUNDTABLE + CFO/CIO ROUNDTABLE Register at www.beckershospitalreview.com 44 CEO SPEAKERS • 33 CFO & CIO SPEAKERS • 99 HOSPITAL SYSTEM SPEAKERS KEYNOTES BY CLEVELAND CLINIC CEO DR. TOBY COSGROVE & ASCENSION CEO DR. ANTHONY TERSIGNI