Supreme Court of the United States
Becerra v. Empire Health Foundation, For Valley Hospital Medical Center
June 24, 2022597 U.S. 424
Summary
The Court upheld HHS’s interpretation of the Medicare disproportionate-share hospital formula: patients are entitled to Medicare Part A benefits when they qualify for the program, even when Medicare does not pay for particular hospital days. Justice Kagan’s opinion, joined by Justices Thomas, Breyer, Sotomayor, and Barrett, relied on statutory text, context, and the formula’s division between Medicare and non-Medicare populations. The Court reversed the Ninth Circuit and remanded. Justice Kavanaugh dissented, joined by Chief Justice Roberts and Justices Alito and Gorsuch. He maintained that the phrase “for such days” requires an entitlement to Medicare payment for the particular hospital days being counted and would reject HHS’s interpretation.
Holding
- Whether Medicare Part A entitlement under the disproportionate-share hospital formula depends on payment for particular hospital days.. Individuals qualifying for Medicare Part A remain entitled to its benefits for purposes of the disproportionate-share hospital formula regardless of whether Medicare pays for particular hospital days. HHS’s 2004 regulation therefore correctly interprets the statute.
Docket 20-1312
Cited authorities
- 42 U.S.C. §§426
- 69 FR 49098
- 42 C.F.R. §412.2
- 42 C.F.R. §409.61
- 69 FR 48916
- 47 Colum. L. Rev. 527
- 42 U.S.C. §426
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