Advocate Christ Medical Center, et al., Petitioners v. Robert F. Kennedy, Jr., Secretary of Health and Human Services

The Supreme Court ruled that hospitals can only count patients for extra Medicare funding if those patients were actually eligible to receive a cash payment during their hospital stay. The Court rejected the hospitals' argument that anyone meeting basic eligibility criteria should count, even if they did not receive a check that month. The decision focused on the specific wording of the law regarding Supplemental Security Income (SSI) benefits.

This ruling limits the amount of extra money hospitals receive for treating low-income patients under the Medicare Disproportionate Share Hospital adjustment. Hospitals that serve many poor patients may see lower reimbursement rates than they had hoped for. This could impact the budgets of medical centers that rely on these federal funds to stay afloat.

The case centers on how much power the government has to set strict rules for complex healthcare funding formulas. It highlights a long-running tension between hospitals seeking more resources and the government trying to limit spending through narrow legal interpretations. The Court's focus on the literal text of the law reflects its current trend of sticking closely to the written words of a statute.

The Court ruled 7-2 to uphold the government's interpretation, with Justice Amy Coney Barrett writing the majority opinion joined by Chief Justice Roberts and Justices Thomas, Alito, Kagan, Gorsuch, and Kavanaugh. Justice Ketanji Brown Jackson wrote a dissenting opinion joined by Justice Sotomayor.

“An individual is 'entitled to [SSI] benefits' ... only if the person is eligible to receive a cash payment during the month of their hospitalization.”

Hospitals will receive less Medicare funding because the Court tied 'entitlement' strictly to the receipt of monthly cash payments.

Lower courts and federal agencies will now apply this strict definition to other pending hospital funding disputes. Hospitals may need to adjust their financial planning to account for lower-than-expected Medicare reimbursements. Advocates for hospitals might also look to Congress to change the law if they want a broader definition of eligibility.

The case focused on whether 'entitled to benefits' means meeting basic program rules or actually being eligible for a cash payment. The Court decided it means being eligible for a payment.

Hospitals that treat many low-income patients will likely receive less federal money. This could make it harder for these facilities to cover the costs of care for the poor.

The Court established that SSI benefits are defined as monthly cash entitlements. Therefore, eligibility must be determined on a month-by-month basis rather than by continuous enrollment.

The Department of Health and Human Services will continue using its current method to calculate payments. Lower courts will follow this precedent (a prior legal decision) for similar cases.

The ruling shows the Court's preference for a 'textualist' approach, which means looking closely at the specific words of a law. It also shows a trend of limiting federal spending.