Supreme Court Rules Against Hospitals' Medicare Funding Claims

The U.S. Supreme Court ruled 7-2 that hospitals serving a large share of low-income patients are not eligible for higher Medicare payments unless their patients actually received Supplemental Security Income (SSI) cash benefits during the month of hospitalization. The Court sided with the Department of Health and Human Services, affirming that only those patients who received SSI checks—not all those enrolled in the SSI program—should be counted in the payment formula. Hospitals had argued for a broader interpretation, claiming the narrower approach undercounts low-income patients and costs them billions in funding, but the majority opinion held that the law’s language requires a strict, month-by-month accounting. Justice Amy Coney Barrett, writing for the majority, emphasized the judiciary must respect the formula Congress established. Dissenting justices argued the decision would deprive hospitals serving the poorest communities of critical federal funds. The ruling impacts reimbursement calculations for years 2006–2009 and could affect billions in payments for hospitals nationwide.