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November 17, 2008

CA1: Medicare fight over research ends in heroic victory for government

RI Hospital v. Leavitt, No. 07-2673.  There is a medicare reimbursement fight.  Essentially, teaching hospitals get paid more for the procedures they perform, because everyone seems to agree that it costs more to run a hospital that teaches.  The question of “how much more” is resolved by calculating a “teaching adjustment factor” which is a hospital’s ratio of full-time equivalent (FTE) residents to its total number of beds.  HHS thinks that the FTE should be reduced by an amount representing time residents spend on research not related to patient care under 42 C.F.R. § 412.105(g)(1).   The First holds that the secretary was within his rights to do so.  This case is only of use to medicare nerds.

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