美国最高法院在费用报销案中对医疗保险提供者作出裁决。沙拉拉诉根西纪念医院案。

Health care law newsletter Pub Date : 1995-06-01
D Rodriguez, A B Hafey
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引用次数: 0

摘要

从长远来看,根西岛的影响将取决于HCFA、提供商报销审查委员会和法院对该决定的解释和应用。如果HCFA将这一决定解释为最高法院愿意给予联邦机构广泛的自由,以避免《行政程序法》的规则制定要求,那么医疗服务提供者在医疗保险计划下正式参与支付政策问题的机会可能会减少。该案件的影响很可能超出了基于成本的报销问题,并影响到医疗保险计划的各个方面。
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United States Supreme Court rules against Medicare providers in cost reimbursement case. Shalala v. Guernsey Memorial Hospital.

In the long run, the impact of Guernsey will depend on the interpretation and application of the decision by HCFA, the Provider Reimbursement Review Board, and the courts. If HCFA interprets the decision as a signal that the Supreme Court is willing to grant federal agencies broad latitude to avoid the rulemaking requirements of the APA, providers may have fewer opportunities for formal input into payment policy issues under the Medicare program. The impact of the case may well go beyond cost-based reimbursement issues and affect all aspects of the Medicare program.

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