Plain-English summary
Court upholds federal rule on which patients count as SSI recipients for higher Medicare hospital payments
The Court affirmed that, for Medicare’s disproportionate-share hospital (DSH) payments, a patient counts as “entitled to” Supplemental Security Income (SSI) if she is eligible to receive an SSI cash payment during the month she’s hospitalized. The decision lets the government use that eligibility standard when calculating hospitals’ higher reimbursement rates.
Why this matters
This case determines how hospitals are judged eligible for higher Medicare payments meant to offset the cost of treating low-income patients. A narrower reading could have reduced payments to many hospitals that serve poor communities, affecting hospital revenue and access to care for low-income patients. The Court’s decision preserves the current method and funding levels tied to that method.
Who may feel it
- Hospitals that treat large numbers of low-income or SSI-eligible patients (especially safety-net hospitals)
- Low-income patients who rely on hospitals that receive DSH payments
- Medicare and Medicaid administrators and state agencies that coordinate SSI eligibility
- Taxpayers and federal budget planners (indirectly, through Medicare spending)