--- title: "SCOTUS: No Provider Relief, SSI Days Must be those Receiving Payment" description: "SCOTUS: No Provider Relief, SSI days must be those receiving payment: “For purposes of the Medicare fraction, an individual is entitled to [SSI] benefits when she is eligible to receive an SSI cash payment during the month of her hospitalization." image: https://public.govdataservices.com/hubfs/Hand%20about%20to%20bang%20gavel%20on%20sounding%20block%20in%20the%20court%20room-1.jpeg --- [Skip to content](https://public.govdataservices.com/the-scoop/scotus-ssi-days-must-be-those-receiving-payment#main-content) Close - [Services](https://public.govdataservices.com/services-page) - [Medicare DSH](https://public.govdataservices.com/medicare-dsh) - [SSI Realignment](https://govdataservices-21378692.hs-sites.com/medicare-dsh#SSI) - [340B MA Underpayments](https://public.govdataservices.com/340b-medicare-advantage-underpayments) - [Medicare Bad Debt](https://public.govdataservices.com/medicare-bad-debt) - [Worksheet S-10 Uncompensated Care](https://public.govdataservices.com/s-10) - [Transfer DRG](https://public.govdataservices.com/transfer-drg) - [Medicare ID & Shadow Billing](https://public.govdataservices.com/medicare-id-shadow-billing) - [MBI ID Finder](https://public.govdataservices.com/mbi-id-finder) - [MIDaS Insurance ID](https://public.govdataservices.com/midas-insurance-id) - [Annual Wellness Visit](https://public.govdataservices.com/annual-wellness-visit) - [Eligibility & Other Services](https://public.govdataservices.com/eligibility-and-other) - [Bundle & Save](https://public.govdataservices.com/bundle-and-save) - [Demo](https://public.govdataservices.com/demo-diagnostics-review) - Resources - [Links](https://public.govdataservices.com/links) - [Blog](https://public.govdataservices.com/the-scoop) - [Contact Us](https://public.govdataservices.com/contact-us) SEARCH [Client Login](https://www.govdataservices.com/gdswebsite/DesktopDefault.aspx) [![GDSlogo\_avenir\_2](https://public.govdataservices.com/hs-fs/hubfs/GDSlogo_avenir_2.png?width=1194&height=340&name=GDSlogo_avenir_2.png)](https://public.govdataservices.com/) - [Services](https://public.govdataservices.com/services-page) - [Medicare DSH](https://public.govdataservices.com/medicare-dsh) - [SSI Realignment](https://govdataservices-21378692.hs-sites.com/medicare-dsh#SSI) - [340B MA Underpayments](https://public.govdataservices.com/340b-medicare-advantage-underpayments) - [Medicare Bad Debt](https://public.govdataservices.com/medicare-bad-debt) - [Worksheet S-10 Uncompensated Care](https://public.govdataservices.com/s-10) - [Transfer DRG](https://public.govdataservices.com/transfer-drg) - [Medicare ID & Shadow Billing](https://public.govdataservices.com/medicare-id-shadow-billing) - [MBI ID Finder](https://public.govdataservices.com/mbi-id-finder) - [MIDaS Insurance ID](https://public.govdataservices.com/midas-insurance-id) - [Annual Wellness Visit](https://public.govdataservices.com/annual-wellness-visit) - [Eligibility & Other Services](https://public.govdataservices.com/eligibility-and-other) - [Bundle & Save](https://public.govdataservices.com/bundle-and-save) - [Demo](https://public.govdataservices.com/demo-diagnostics-review) - Resources - [Links](https://public.govdataservices.com/links) - [Blog](https://public.govdataservices.com/the-scoop) - [Contact Us](https://public.govdataservices.com/contact-us) [Client Login](https://www.govdataservices.com/gdswebsite/DesktopDefault.aspx) [Chris Cusimano](https://public.govdataservices.com/the-scoop/author/chris-cusimano) Apr 29, 2025, 1:05:20 PM 2 min read # SCOTUS: No Provider Relief, SSI Days Must be those Receiving Payment [Previous](https://public.govdataservices.com/the-scoop/revenue-opportunity-significant-non-par-medicare-advantage-volume-2018-2022) [Next](https://public.govdataservices.com/the-scoop/critical-ssi-error-identified-in-post-advocate-christ-remand-letter-review) Today, the Supreme Court of the United States (SCOTUS) affirmed the D.C. Circuit’s decision in *Advocate Christ Medical Center v. Secretary of Health and Human Services* by a 7-2 vote, with Justices Jackson and Sotomayor dissenting. In the majority opinion, the Court stated: “For purposes of the Medicare fraction, an individual is entitled to \[SSI\] benefits when she is eligible to receive an SSI cash payment during the month of her hospitalization. §1395ww(d)(5)(F)(vi)(I). We must respect the formula that Congress prescribed. \[...\] For the foregoing reasons, we affirm the judgment of the Court of Appeals.” While the Court must weigh many legal and statutory considerations, the outcome—particularly when viewed in tandem with the *Empire* ruling and the final interpretation of Medicaid days—presents a confusing landscape to the lay observer. In particular, the term “entitled” is potentially interpreted inconsistently within the same statute. For Medicare Part A, being “entitled” does not require a beneficiary to receive benefits, a point clarified in *Empire*. However, in the context of Supplemental Security Income (SSI), the Court now interprets “entitled” to mean that benefits must be received—not just eligibility established. Meanwhile, Medicaid days have long been evaluated based on “eligibility” alone, aligning more with the Part A interpretation of “entitled”. Taken together, the *Advocate*, *Empire*, and original *Allina* rulings largely resolve a decades-long legal battle concerning Medicare DSH—ultimately siding with the government and curbing reimbursement amounts for safety-net hospitals. Yet not all issues are settled: offshoot cases from *Allina* remain pending before the Provider Reimbursement Review Board (PRRB) and continue to surface in other courts under different legal theories. ![avatar](https://public.govdataservices.com/hs-fs/hubfs/chriscusimano.jpg?width=290&name=chriscusimano.jpg) #### [Chris Cusimano](https://public.govdataservices.com/the-scoop/author/chris-cusimano) ## RELATED ARTICLES ### [Chris Cusimano Jun 4, 2024, 12:13:17 PM 2 min read CMS Ruling 1498-R3: A Partially Murky Resolution of SSI Ratio's Sordid History The SSI ratio is a critical factor in determining the amount of Medicare DSH Reimbursement. Start Reading](https://public.govdataservices.com/the-scoop/cms-ruling-1498-r3-a-partially-murky-resolution-of-ssi-ratios-sordid-history) ### [Chris Cusimano Aug 30, 2023, 3:42:31 PM 2 min read 340B Remedy: Action Items from Client Analysis & Attorney Discussions In July, GDS blogged about the proposed remedy for the well-known illegal 340B payment policy. Subsequently, client demand ... Start Reading](https://public.govdataservices.com/the-scoop/340b-remedy-action-items-from-client-analysis-attorney-discussions) ### [Chris Cusimano Aug 5, 2026, 4:49:16 PM 1 min read CMS FFY 2027 Rehabilitation Final Rule The FFY 2027 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) Final Rule has been published by CMS, The ... Start Reading](https://public.govdataservices.com/the-scoop/cms-ffy-2027-rehabilitation-final-rule) [![gds-logo-1](https://public.govdataservices.com/hs-fs/hubfs/gds-logo-1.png?width=500&height=150&name=gds-logo-1.png)](https://public.govdataservices.com/) **Get in Touch** Government Data Services 3200 W. Market St., Ste. 102 Akron, OH 44333-3324 Government Data Services 117 Seaboard Lane, F270 Franklin, TN 37067 Toll Free: (800) 370-7397 Email: [info@govdataservices.com](mailto:info@govdataservices.com) ![soc](https://public.govdataservices.com/hs-fs/hubfs/soc.jpg?width=44&name=soc.jpg)[![digicert](https://public.govdataservices.com/hs-fs/hubfs/digicert.png?width=117&name=digicert.png)](https://seal.digicert.com/seals/popup/?tag=VtfrmabA&url=www.govdataservices.com) © 2026 - Government Data Services LLC. All rights reserved - [Site Use Agreement](https://public.govdataservices.com/terms-of-use) - [Confidentiality and Privacy](https://public.govdataservices.com/privacy) ```json { "@context" : "http://schema.org", "@type" : "Organization", "knowsLanguage" : "en", "name" : "", "url" : "https://public.govdataservices.com/the-scoop/scotus-ssi-days-must-be-those-receiving-payment" } ``` ```json { "@context" : "http://schema.org", "@type" : "BlogPosting", "abstract" : "SCOTUS: No Provider Relief, SSI days must be those receiving payment: “For purposes of the Medicare fraction, an individual is entitled to [SSI] benefits when she is eligible to receive an SSI cash payment during the month of her hospitalization.", "author" : { "@type" : "Person", "name" : "Chris Cusimano" }, "dateModified" : "April 29, 2025 5 PM", "datePublished" : "April 29, 2025 5 PM", "headline" : "SCOTUS: No Provider Relief, SSI Days Must be those Receiving Payment", "image" : "https://21378692.fs1.hubspotusercontent-na1.net/hubfs/21378692/Hand%20about%20to%20bang%20gavel%20on%20sounding%20block%20in%20the%20court%20room-1.jpeg", "inLanguage" : "en", "keywords" : "[Legal News, SSI]", "mainEntityOfPage" : { "@type" : "WebPage" }, "name" : "SCOTUS: No Provider Relief, SSI Days Must be those Receiving Payment", "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "" }, "name" : "" }, "text" : "Today, the Supreme Court of the United States (SCOTUS) affirmed the D.C. Circuit’s decision in Advocate Christ Medical Center v. Secretary of Health and Human Services by a 7-2 vote, with Justices Jackson and Sotomayor dissenting. In the majority opinion, the Court stated: “For purposes of the Medicare fraction, an individual is entitled to [SSI] benefits when she is eligible to receive an SSI cash payment during the month of her hospitalization. §1395ww(d)(5)(F)(vi)(I). We must respect the formula that Congress prescribed. [...] For the foregoing reasons, we affirm the judgment of the Court of Appeals.” While the Court must weigh many legal and statutory considerations, the outcome—particularly when viewed in tandem with the Empire ruling and the final interpretation of Medicaid days—presents a confusing landscape to the lay observer. In particular, the term “entitled” is potentially interpreted inconsistently within the same statute. For Medicare Part A, being “entitled” does not require a beneficiary to receive benefits, a point clarified in Empire. However, in the context of Supplemental Security Income (SSI), the Court now interprets “entitled” to mean that benefits must be received—not just eligibility established. Meanwhile, Medicaid days have long been evaluated based on “eligibility” alone, aligning more with the Part A interpretation of “entitled”. Taken together, the Advocate, Empire, and original Allina rulings largely resolve a decades-long legal battle concerning Medicare DSH—ultimately siding with the government and curbing reimbursement amounts for safety-net hospitals. Yet not all issues are settled: offshoot cases from Allina remain pending before the Provider Reimbursement Review Board (PRRB) and continue to surface in other courts under different legal theories.", "url" : "https://public.govdataservices.com/the-scoop/scotus-ssi-days-must-be-those-receiving-payment", "wordCount" : "362" } ``` ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Chris Cusimano", "url" : "https://public.govdataservices.com/the-scoop/author/chris-cusimano" }, "dateModified" : "2025-04-29T17:07:52.185Z", "datePublished" : "2025-04-29T17:05:20.000Z", "headline" : "SCOTUS: No Provider Relief, SSI Days Must be those Receiving Payment", "image" : [ "https://public.govdataservices.com/hubfs/Hand%20about%20to%20bang%20gavel%20on%20sounding%20block%20in%20the%20court%20room-1.jpeg" ], "mainEntityOfPage" : { "@id" : "https://public.govdataservices.com/the-scoop/scotus-ssi-days-must-be-those-receiving-payment", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject" } } } ```