Asociacion Hospital del Maestro, Inc. v. Becerra, No. 19-1475 (1st Cir. 2021)
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In this action brought by a group of twenty-five acute-care hospitals in Puerto Rico that received disproportionate share hospital payments (DHS payments) from the government, the First Circuit affirmed the decision of the district court denying relief on Plaintiffs' allegations that the Secretary of the United States Department of Health and Human Services improperly calculated their DSH payments, holding that the district court did not err.
When Congress included hospitals in Puerto Rico in providing coverage for the DSH reimbursement program, the DSH payments were often substantially less than the DSH payments provided to similarly-situated hospitals in the states. This disparity was the result of the application to hospitals in Puerto Rico of the existing statutory formula used to calculate DSH payments to hospitals in the states. Plaintiffs brought this action challenging the Secretary's interpretation and application of the statutory formula, arguing that it was inconsistent with the Medicare Act, the Administrative Procedure Act, and the Equal Protection Clause of the United States Constitution. The district court denied relief. The First Circuit affirmed, holding that the Secretary did not err in implementing the statute and that Plaintiffs failed to show that they were the victims of any unconstitutional discrimination by the Secretary.
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