It is undisputed, as the Court notes, ante, at 2, that respondent, Guernsey Memorial Hospital ( Hospital ), is entitled to reimbursement for the reasonable advance refunding costs it incurred when it refinanced its capital improvement bonds in 1985.
12.
PRM s233, which departs from the GAAP rule concerning advance refunding losses, does not have the force of a regulation because it was promulgated without notice and comment as required by the Administrative Procedure Act, 5 U . S . C . s553.
13.
As comptroller, Hevesi adopted a policy of refusing to allow an advance refunding to go forward unless it provided a certain level of savings up front and did not drive up the amount of money that the city had to pay on debt service in any future year.
14.
It is certainly true that the Act prohibits the Medicare program from bearing more or less than its proper share of hospital costs, 42 U . S . C . s1395x ( v ) ( 1 ) ( A ) ( i ), but immediate recognition of advance refunding losses does not violate this principle.
15.
If the Secretary had the opportunity to include a section on advance refunding costs in the PRM, then she could have promulgated a regulation to that effect in compliance with the Administrative Procedure Act, thereby giving the public a valuable opportunity to comment on the regulation's wisdom and those adversely affected the chance to challenge the ultimate rule in court.
16.
In fact, what testimony there is supports the view that it is appropriate to recognize advance refunding losses in the year of the transaction because the provider no longer carries the costs of the refunded debt on its books thereafter; the losses in question simply represent a one-time recognition of the difference between the net carrying costs of the old bonds and the price necessary to reacquire them.
