[Oral Argument Not Yet Scheduled]

USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 13 of 633 Many hospitals are entitled to an increase in Medicare payments— the disproportionate-share-hospital (colloquially, “DSH”) adjustment, 42 U.S. C. [...] USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 18 of 638 Congress did not intend any of this. It enacted a simple provision that broadly allows hospitals to seek immediate review of any final CMS determination that reduces the payment amounts they will receive— including the DSH adjustment. [...] § 1395oo(a)(1)(A)(ii), because it had direct legal consequences and represented the agency’s USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 19 of 639 definitive position at that time. [...] For good reason: The “policy of counting Part C patients in the Medicare fraction” directly “affects a hospital’s right to payment.” Azar v. [...] USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 20 of 6310 The Part C determination also reflected CMS’s definitive position at that time. [...] 30) that the DSH adjustment consists of “two variable inputs”: the USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 34 of 6324 Medicare and Medicaid fractions. It concedes (Br. [...] Sebelius, 657 F.3d USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 38 of 6328 1, 20 n.1 (D.C. Cir. 2011) (Kavanaugh, J., concurring in the judgment). [...] MedPac, USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 42 of 6332 Report to the Congress: Medicare and the Health Care Delivery System 183-185 (June 15, 2021), . [...] 23, supra—determinations that would be imme- USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 45 of 6335 diately reviewable in virtually any other corner of the administrative state. [...] (x) Subject to clause (xiv), for purposes of clause (iv)(VI) (relating to sole community hospitals), in the case of a hospital for a cost reporting USCA Case #23-5310 Document #2067166 Filed: 07/29/2024 Page 58 of 63Add.