The question
Whether a patient counts as "entitled to supplementary security income benefits" for the Medicare fraction only when eligible to receive an SSI cash payment during the month of hospitalization.
Advocate Christ Medical Center v. Kennedy
What the Court decided
The Court affirmed the D.C. Circuit and ruled for the government, so HHS may continue counting a patient in the Medicare fraction only when the patient is eligible to receive an SSI cash payment during the month of hospitalization. SSI benefits are cash benefits, and subchapter XVI determines eligibility for them on a monthly basis. The hospitals' reading, which would count everyone enrolled in the SSI system at the time of hospitalization, fails because non-cash benefits do not qualify as SSI benefits under subchapter XVI and because eligibility is fixed month by month.
How the justices split
7-2The Court's opinion
Barrett, joined by Roberts, Thomas, Alito, Kagan, Gorsuch, Kavanaugh
The opinion held that a patient is entitled to SSI benefits for the Medicare fraction only when eligible to receive an SSI cash payment during the month of hospitalization. SSI benefits under subchapter XVI are cash benefits, quantified in dollar amounts and paid to eligible individuals, and eligibility for them is determined month by month based on the individual's income, resources, and other characteristics in that month. Consistent with Empire Health, the opinion treated "entitled" as synonymous with being eligible for benefits. It rejected the hospitals' reading that non-cash items such as vocational rehabilitation services and continued Medicaid coverage are SSI benefits, finding none housed under subchapter XVI, and rejected the argument that eligibility persists until 12 consecutive months of ineligibility. It also declined to override the statutory formula on grounds of legislative purpose.
Dissenting
Jackson, joined by Sotomayor
Justice Jackson filed a dissenting opinion, joined by Justice Sotomayor, disagreeing with the Court's construction of "entitled to SSI benefits" in the Medicare fraction.
How we know · 5 sourced claims
The Court held that an individual is entitled to SSI benefits for the Medicare fraction when she is eligible to receive an SSI cash payment during the month of her hospitalization.
Source: syllabus, Held
The Court affirmed the judgment of the D.C. Circuit reported at 80 F.4th 346.
Source: syllabus, Held
Justice Barrett delivered the opinion of the Court, joined by Roberts, Thomas, Alito, Kagan, Gorsuch, and Kavanaugh.
Source: syllabus, lineup
Justice Jackson filed a dissenting opinion, in which Justice Sotomayor joined.
Source: syllabus, lineup
The Court rejected the petitioner hospitals' reading that non-cash items and system enrollment count as entitlement to SSI benefits under subchapter XVI.
Source: syllabus, Held