In a 7-1 decision, the U.S. Supreme Court ruled in a case that could have positive ramifications for rural hospitals nationwide. In 2014, the Obama administration revealed a new policy on its website that “dramatically and retroactively reduced payments to hospitals serving low income patients,” noted Justice Neil Gorsuch who wrote the Court’s opinion. In Azar v. Allina Health Services, the justice said HHS needed to provide advance notice and a chance to comment on a decision that changed the “disproportionate-share hospital” (DSH) program reimbursement payments under Medicare. With Medicare spending about $700 billion annually, "even seemingly modest modifications to the program can affect the lives of millions,” Gorsuch noted. The DSH cuts have been delayed since 2014 but were scheduled to take effect in 2020, starting with a $4 billion reduction.

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