Baylor University Medical Center v. Heckler
Baylor University Medical Center v. Heckler
Opinion of the Court
Under Title XVIII of the Social Security Act (“Medicare Act”), 42 U.S.C. § 1395, et seq., hospitals providing health care services to Medicare patients are to be paid by the Secretary of the Department of Health and Human Services (“Secretary”) their
The district court agreed with the hospitals’ position and held that labor and delivery room patients are not includable in the midnight census used to compute the average cost of routine services for purposes of Medicare reimbursement. Baylor University Medical Center v. Schweiker, 563 F.Supp. 1081 (N.D.Tex. 1983). We affirm on the basis of the reasons adequately set forth in the district court’s opinion and by the Courts of Appeals for the District of Columbia Circuit and Ninth Circuit in St. Mary of Nazareth Hospital Center v. Schweiker, 718 F.2d 459 (D.C.Cir. 1983) and International Philanthropic Hospital Foundation v. Heckler, 724 F.2d 1368 (9th Cir. 1984). Our affirmance, however, is of this case only and should not be construed to invalidate the practice of including labor and delivery room patients in the inpatient census in all situations. Hospital practices vary, and the Secretary is free to produce evidence showing that the artificially low reimbursement alleged to result from including labor and delivery room patients in the census is offset by other accounting factors, including those recognized in St. Mary of Nazareth Hospital Center and International Philanthropic Hospital Foundation.
AFFIRMED.
Reference
- Full Case Name
- BAYLOR UNIVERSITY MEDICAL CENTER v. Margaret M. HECKLER, Secretary, Department of Health and Human Services, Defendant-Appellant HARRIS HOSPITAL-METHODIST v. Margaret M. HECKLER, Secretary, Department of Health and Human Services
- Cited By
- 25 cases
- Status
- Published