NOTE AND COMMENT: Presbyterian Hospital of Dallas v. Harris : A Dubious Consequence of Piecemeal Health Care Legislation Skip over navigation
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Copyright (c) 1983 Boston University School of Law.
American Journal of Law & Medicine

NOTE AND COMMENT: Presbyterian Hospital of Dallas v. Harris: A Dubious Consequence of Piecemeal Health Care Legislation


9 Am. J. L. and Med. 205


Deborah K. Berk



In 1946, Congress passed the Hospital Survey and Construction Act, 1 popularly known as the Hill-Burton Act, to help the states provide adequate hospital services to all citizens. 2 The Act established federal funding for construction and modernization of hospital facilities. Despite repeated amendment, Congress has retained the Act's original requirement that hospitals receiving Hill-Burton funds provide a certain amount of free services to indigents. 3 For years many hospitals ignored their Hill-Burton obligations; 4 in the early 1960's, indigents who were denied free health care initiated suits against hospitals and the federal government to compel compliance with the Act. 5

Counts interpreted the Hill-Burton Act to emphasize an underlying congressional intent to provide health care to all who need it. 6 Federal regulators acquiesced to the judicial mandate by expanding the Hill Burton obligations of recipient hospitals. 7 Hospitals reacted by seeking additional federal monies from Medicare to reimburse their Hill-Burton free care costs. The Secretary of Health and Human Services (HHS) 8 opposed Medicare reimbursement of Hill-Burton expenditures as contrary to the congressional intent behind both the Hill-Burton and Medicare Acts. 9

The Medicare Act entitles hospitals to reimbursement for reasonable costs incurred in providing services to Medicare patients. 10 These costs include a share of the hospital's general operating expenses, based upon the proportion of Medicare patients served. The Hill-Burton Act provides hospitals with federal funds for construction of new facilities; receipt of these funds obligates hospitals to provide a certain ...
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