The amount of attention devoted to the health care system seems to be increasing every day as affordable care legislation implementation and its attendant costs continue to attract attention both in Washington and on Main Street.

While the politics are sorted out, the day-to-day operation of the Medicare reimbursement system and its impact on providers continues. When a provider files for bankruptcy, the debtor-creditor relationship between the Medicare system and provider sometimes plays out in interesting ways. Given the importance of Medicare payments to the continued operation of a hospital, the Medicare administrator must balance the government’s right to obtain repayment of overpayments to a hospital with the need to continue providing cash flow to allow the facility to continue operations.