Panel Upholds Claim Denial; ACA Medicare Reimbursement Standard Prospective

Mealey's (June 16, 2015, 9:41 AM EDT) -- CINCINNATI — A hospital’s claim involves pre-Patient Protection and Affordable Care Act (ACA) Medicare reimbursement standards, and its attempt to have its claim reopened is pointless since it cannot prevail under the prior law’s “substantially all” standard, a Sixth Circuit U.S. Court of Appeals panel held Feb. 24 (Covenant Medical Center Inc. v. Secretary of Health and Human Services, Sylvia Mathews Burwell, No. 14-1383, 6th Cir.; 2015 U.S. App. LEXIS 3011).

(Opinion available. Document #93-150325-020Z.)

Covenant Medical Center partially funds Synergy Medical Education Alliance, which operates...
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