On August 13, 2019, the D.C. Circuit Court of Appeals overturned a lower court’s nationwide injunction order that had vacated a Centers for Medicare and Medicaid Services (CMS) final rule that permitted payments from Medicare and private insurers to be included in calculating the hospital-specific limit on Medicaid DSH payments.

On Monday, June 3, 2019, the U.S. Supreme Court upheld a Court of Appeals ruling that stated a 2014 regulation of the Centers for Medicare and Medicaid Services (CMS) – that reduced DSH payments to hospitals servicing indigent patients – should be removed for failure to follow proper notice and comment requirements. 

On October 26, 2018, Judge Ketanji Jackson of the U.S. District Court for the District of Columbia ruled that certain patient days for individuals in the Commonwealth Care program should be included in calculating DSH Medicare reimbursement for 12 Massachusetts hospitals serving large numbers of poor patients. 

On September 27, 2018, the U.S. Supreme Court agreed to take up an appeal of a decision by the U.S. Court of Appeals for the District of Columbia against the Department of Health and Human Services (HHS) concerning certain past payments to a number of mostly non-profit hospitals under the Medicare Disproportionate Share Hospital (DSH) program.