No. 10-5115.

642 F.3d 1145 (2011)

AUBURN REGIONAL MEDICAL CENTER, et al., Appellants v. Kathleen SEBELIUS, Secretary, Department of Health and Human Services, Appellee.

United States Court of Appeals, District of Columbia Circuit.

Decided June 24, 2011.

Attorney(s) appearing for the Case

Robert L. Roth argued the cause and filed the briefs for appellants.

M. Roy Goldberg , Christopher M. Loveland , and Brian M. Daucher were on the brief for amici curiae Hospice Advantage, et al. in support of appellants.

Jeffrey A. Lovitky was on the brief for amicus curiae Quality Reimbursement Services in support of appellants.

Stephanie R. Marcus , Attorney, U.S. Department of Justice, argued the cause for appellee. With her on the brief were Ronald C. Machen Jr. , U.S. Attorney, and Mark B. Stern , Attorney. Samantha L. Chaifetz , Attorney, and R. Craig Lawrence , Assistant U.S. Attorney, entered appearances.

Opinion for the Court filed by Circuit Judge GRIFFITH.

GRIFFITH, Circuit Judge:

Since 1983, Medicare has used a prospective payment system to reimburse hospitals for their inpatient operating costs. These payments are based on predetermined, nationally applicable rates and are subject to various adjustments. One such adjustment is the disproportionate share hospital (DSH) payment, which provides an additional reimbursement to hospitals that serve large numbers of low-income patients. A hospital's DSH payment depends on...

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