HealthEast Bethesda Lutheran Hospital & Rehabilitation Center v. Shalala

MORRIS SHEPPARD-ARNOLD, Circuit Judge.

The Medicare program reimburses hospitals for interest payments on “necessary” loans to the extent that such payments exceed income on the hospitals’ investments. See 42 C.F.R. § 413.153(a)(1). When deciding how much to reimburse a hospital for a particular year, therefore, the Department of Health and Human Services must determine whether a loan is necessary and what the hospital’s investment income is. Each year, hospitals submit cost reports to “fiscal intermediaries,” who are under contract with the Department of Health and Human Services and who…