Advocate Christ Medical Center v. Kennedy, 605 U.S. 1

Medicare reimburses hospitals using a formula that provides extra funds to hospitals that serve many low-income patients, known as the Disproportionate Share Hospital (DSH) adjustment.
The DSH formula includes a “Medicare fraction,” which counts patient days for Medicare patients who are also "entitled to Supplemental Security Income (SSI) benefits" under subchapter XVI.
The statutory phrase “entitled to [SSI] benefits” is not expressly defined as to whether this means all SSI enrollees or only those eligible for a cash payment in the specific month of hospital care.
The Department of Health and Human Services (HHS) interprets this to include only patients eligible for an SSI cash payment in the hospital month; a group of over 200 hospitals sued, claiming the formula undercounts low-income patients and results in underpayment.
Lower courts (including the D.C. Circuit) sided with HHS, finding the agency’s interpretation consistent with the statute’s focus on cash payments and monthly eligibility.
The Supreme Court granted certiorari to resolve the interpretive dispute and affirmed the lower court’s judgment, holding that “entitled to [SSI] benefits” refers only to months when the patient was eligible for an SSI cash payment.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Meaning of “entitled to [SSI] benefits” in the DSH formula	Includes all enrolled SSI patients during hospitalization, regardless of payment that month	Only patients eligible for an SSI cash payment during the hospital month are counted	Only those eligible for an SSI cash payment that month are "entitled" to SSI benefits
Inclusion of non-cash SSI benefits	SSI includes non-cash benefits (e.g., Medicaid, vocational rehab); these should count	Only cash benefits under subchapter XVI count for the formula	Only cash SSI payments under subchapter XVI count
Annual vs. monthly eligibility for SSI	SSI eligibility is annual (not just monthly), so patients should be counted if generally eligible	SSI eligibility and payments are determined monthly by statute	SSI entitlement is determined monthly
Statutory purpose and rationality	Broader reading to further Congress’s intent to help hospitals serving low-income patients	Congress chose a specific, administrable formula based on monthly eligibility	Court must apply Congress’s chosen formula, not rewrite the statute

United States v. Detroit Timber & Lumber Co., 200 U.S. 321 (discussing the non-binding nature of the syllabus)
Becerra v. Empire Health Foundation, for Valley Hospital Medical Center, 597 U.S. 424 (addressing the interpretation of “entitled to [Medicare Part A] benefits” in the DSH context; relevance of benefit program characteristics)
Sebelius v. Auburn Regional Medical Center, 568 U.S. 145 (explains DSH payment adjustments for hospitals serving low-income patients)
Schweiker v. Wilson, 450 U.S. 221 (describes the purpose of SSI as a subsistence allowance for the needy)
Bowen v. Galbreath, 485 U.S. 74 (confirms SSI is a welfare program)
Bartenwerfer v. Buckley, 598 U.S. 69 (court must respect statutory choices rather than policy preferences)
Luna Perez v. Sturgis Public Schools, 598 U.S. 142 (statutory construction—no statute serves one purpose at all costs)
Kucana v. Holder, 558 U.S. 233 (purpose does not override statutory text)
Rodriguez v. United States, 480 U.S 522 (per curiam) (emphasizes legislative compromise over single policy enforcement)