Waltz Quoted on SCOTUS Ruling Over Medicare Payments

Partner Judith Waltz was quoted in a Compliance Cosmos article, “In Ruling That Will Shake Up How CMS Issues Guidance, Supreme Court Rejects DSH Formula,” about a U.S. Supreme Court decision throwing out a Medicare formula for calculating disproportionate share hospital (DSH) payments because it never went through formal rulemaking.

Going forward, Waltz said, there still are a lot of open issues that will need to be hashed out in the courts. “CMS will take an action and someone will go into court and say, ‘that’s an invalid action because the underlying requirement was not noticed and commented, so we can’t be held to that standard because it’s just CMS’s opinion,’” she said.

It’s also unclear what the decision means for routine guidance, Waltz said. “CMS can take the risk and say its guidance is only interpretive, but I think it will be another area of challenge,” she said.

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