SEATTLE (AP) - Large hospitals around Washington state go to federal court Friday seeking millions in federal payments for some indigent patients who aren't eligible for Medicaid or Social Security.

Such patients are typically younger, only partially disabled and without dependent children. For example, a military veteran in his 40s who can't work because of a damaged vertebra in his neck and mental problems.

Such a person would be ineligible for Social Security or Medicaid, even though he subsisted mainly on food stamps and about $300 a month from a state welfare program for the unemployable.

When such a person goes to a hospital in Washington, the state covers some of the cost, but the hospital would get more money from the federal government if he qualified for Social Security and Medicaid.

The University of Washington Medical Center and 17 other large hospitals in Washington state are seeking higher reimbursement for such cases from the U.S. Department of Health and Human Services, arguing that the federal government should pay for such patients because it did so in some other states before 2000.

The two sides largely agree on the facts and have asked Judge Richard A. Jones to issue a summary judgment without a trial.

At stake is about $31 million in payments the hospitals argue they should have received for the years 1994 to 2000 and potentially millions more from later years, said Del Nord, a Medicaid compensation specialist in the Spokane office of Quality Reimbursement Services of Arcadia, Calif.

If the hospitals lose, it could hurt their financial help and eventually service to all patients, said Beth Zborowski, a spokeswoman for the Washington State Hospital Association, because the costs would be shifted to other insurance programs. That could lead to higher insurance rates and more people who can't afford insurance.

"The hospitals have to cover the cost of providing that care," Zborowski said. "We do have a moral obligation to provide treatment."

If the hospitals win, the case could wind up in the Supreme Court, which declined to review a ruling against a hospital in Ohio earlier this month.

The case could reverberate around the country, said Joshua Freemire, a Baltimore, Md., lawyer who handles Medicaid reimbursement cases.

"If all these hospitals were going to come forward with $50 million claims, how that would affect the Social Security trust fund, we don't know," Freemire said.

Overall Medicaid payments in Washington state have declined from 90 percent of hospitals' costs in 1995 and 82.5 percent today, said Cassie Sauer, another association spokeswoman.

"At some point the system breaks," Zborowski said. "People will not be able to go to their community hospitals for the services they once received."

The issue turns on dense federal regulations, complex administrative procedures and state Medicaid plans that can run to thousands of pages.

At the center are patients who don't qualify for Medicaid under federal rules but receive hospital treatment under state programs that use Medicaid money as part of a larger system for providing medical care to the poor.

Hospitals get Medicaid reimbursement partly based on how many eligible patients they serve. Hospitals with high numbers of indigent patients get extra money.

Hospitals contend they should be allowed to count patients covered by programs for the poor that include Medicaid, arguing that they fit the definition of indigent in the federal law.

The lawsuit covers two types of patients, one from a program that was discontinued in 2003 and the other, called General Assistance-Unemployable, which currently covers about 17,000 people.

There had been varying practices nationwide on which patients qualify for the extra payments, said John Jacob, a Washington, D.C, lawyer who tracks Medicaid reimbursement.

Federal officials agreed not to take money back from hospitals that had received extra money by counting such patients before 2000, but warned they wouldn't be counted afterward, Jacob said.

Adena Regional Medical Center in Chillicothe, Ohio, challenged that policy and won in U.S. District Court, but that decision was reversed on appeal and Supreme Court declined to hear the case.

Phoenix Memorial Hospital and seven others in Arizona filed a similar challenge but lost in U.S. District Court in January.

A case brought by Cooper University Hospital in Camden, N.J., is awaiting a hearing on motions for summary judgment in U.S. District Court.

Similar cases may emerge in other states as well.

"If we lose this one, I think everybody in the country can fold their cases and go home," Nord said of the Washington state case. "This is the best case I have seen across the country."