The Medicare program isn’t required to reimburse Pennsylvania hospitals for services to patients deemed needy under a state formula, only for those who qualify for aid under the federal formula, the Third Circuit has ruled in a reversal of the district court.
Hospitals that handle a larger-than-average share of low-income patients are eligible for a Medicare reimbursement adjustments program for “disproportionate share hospitals” depending on the number of “patient days” they have, according to the opinion. “Patient days” are days on which the hospital serves low-income patients.
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