More than half of the nation’s hospitals are being penalized by Medicare for readmitting too patients.

Together, they will loses $420 million in Medicare payments.

The penalties are part of Medicare’s hospital readmissions reduction program, which penalizes hospitals for readmitting too many patients within 30 days of their discharge. The program was created by the Affordable Care Act to encourage hospitals to pay more attention to the quality of care they deliver and the care they take when discharging patients.

Some hospitals are being penalized even though their performance has improved under the program.

The National Association of Urban Hospitals (NAUH) has long maintained that the program unfairly penalizes private safety-net hospitals that care for patients whose problems often go beyond medical concerns and are therefore more difficult to serve.  NAUH has conveyed these concerns to officials of the Centers for Medicare & Medicaid Services.

For more information about the latest round of penalties, see this Kaiser Health News story.