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No. 20-1312October Term 2020Decided Jun 24, 2022

Docket 20-1312October Term 2020 (2020–2021)

Becerra v. Empire Health Foundation, For Valley Hospital Medical Center

The Court is being asked to clarify a technical Medicare payment formula with potentially large financial effects for hospitals.

Case status

Current stage
Decided
Latest event
Decision released Jun 24, 2022
Case Accepted
Arguments
Decision ReleasedJun 24, 2022
What it's about

This case was about how the federal government calculates extra Medicare payments for hospitals that treat many low-income patients. The dispute centered on whether patients who qualify for Medicare Part A count in the Medicare part of that formula even if Medicare did not actually pay for their hospital stay, and the Court held that they do.

Question presented

Whether the Secretary has permissibly included in a hospital's Medicare fraction all of the hospital's patient days of individuals who satisfy the requirements to be entitled to Medicare Part A benefits, regardless of whether Medicare paid the hospital for those particular days.

Case path

United States Court of Appeals for the Ninth Circuit / Decision released Jun 24, 2022

Area

Decided Supreme Court case

Briefing

What it's about

The case asks how the federal government should count hospital days in a Medicare formula that helps determine extra payments for hospitals serving many low-income patients. The dispute is whether days for patients who qualify for Medicare Part A should count in the Medicare share even when Medicare did not pay for that specific hospital stay.

Vote

No oral argument is scheduled yet. The parties disagree over whether the formula should turn on a patient's entitlement to Medicare Part A benefits or on whether Medicare actually paid for the hospital stay.

Impact

The answer could change how much money some hospitals receive from Medicare, especially hospitals that treat many poorer patients. For example, a safety-net hospital's annual reimbursement could rise or fall depending on which patient days are included in the formula.

What's next

The next key move is scheduling oral argument or another action from the Court. No decision window is available yet.

What is the core dispute in Becerra v. Empire Health Foundation?

The fight is over whether certain hospital days count because a patient qualified for Medicare Part A, even if Medicare did not pay. That choice affects a payment formula for hospitals serving many low-income patients.

Why could this case matter in the real world?

It could change Medicare payments for hospitals that care for many low-income patients. That can affect hospital budgets and resources for patient care.

What should readers watch for next in this case?

Watch for the Supreme Court to schedule oral argument or make another calendar move. Until then, there is no set timeline for a final decision.

Decision

Decision record

What the Court decided

The Court is being asked to clarify a technical Medicare payment formula with potentially large financial effects for hospitals.

Impact

The answer could change how much money some hospitals receive from Medicare, especially hospitals that treat many poorer patients. For example, a safety-net hospital's annual reimbursement could rise or fall depending on which patient days are included in the formula.

Not official Court text.

Opinion documents

Timing

Decided June 24, 2022

The Court released its decision on June 24, 2022 without hearing oral argument.