The case, Becerra v. Empire Health Foundation, hinges on a highly technical issue.
To calculate DSH adjustments, HHS adds together two statutorily described fractions: the Medicare fraction, representing the proportion of a hospital’s Medicare patients who are low-income; and the Medicaid fraction, representing the proportion of a hospital’s total patients who aren’t on Medicare but are low-income.
Not all patients who qualify for Medicare have their inpatient treatment paid for by the program. There are a variety of limits, such as if a patient’s hospital stay exceeds 90 days.
