Supreme Court -- health business coverage from STAT
J. Scott Applewhite/AP

Tuesday’s oral arguments before the Supreme Court in a case involving billions in Medicare payments to hospitals revealed a split among the justices willing to show their cards. 

The case, Advocate Christ Medical Center v. Becerra, concerns Medicare payments to safety net hospitals, known as disproportionate share hospital, or DSH, payments, which are designed to compensate them for treating low-income patients. The more than 200 hospitals who brought the case argue the federal Department of Health and Human Services isn’t paying them enough because it takes too narrow a view of which patients should be counted toward their payments. 

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Two lower courts have already sided with HHS. A federal appeals court noted in its own ruling that “at every turn,” the Medicare law in question equates SSI eligibility with “cash payments,” so only patients who received payments should be counted toward the DSH calculations. 

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