Hospitals Appeal Ruling On Outpatient Payments

May 23, 2017

Dozens of hospitals across the state have appealed an administrative law judge's decision in a dispute about reimbursement rates for outpatient care of Medicaid beneficiaries.

The hospitals filed notices of appeal last week at the 1st District Court of Appeal, after a decision in April by Judge J. Lawrence Johnston in favor of the state Agency for Health Care Administration.

As is common, the notices of appeal do not detail the hospitals' legal arguments. The cases began late last year when hospitals challenged a methodology for determining reimbursement rates.

The hospitals argued, in part, that the methodology had not been adopted as a rule, as required, Johnston's decision said. The hospitals filed additional challenges in January, after the Agency for Health Care Administration said it was amending a rule to incorporate the methodology. But Johnston, in a 28-page decision April 18, turned down the hospitals' arguments.