River Region expects to cut care for La. Medicaid patients|[05/16/08]

Published 12:00 am Friday, May 16, 2008

Barring passage of a Medi-caid reimbursement bill in this year’s session of the Louisiana Legislature, River Region Medical Center will stop non-emergency care for Medicaid patients from that state July 1.

Letters will be sent to patients and physicians notifying them of the possible change, telling them River Region and its affiliates, which include most medical services in Vicksburg, can no longer afford to treat Louisiana Medicaid patients because reimbursement rates have remained 50 percent less than the rate paid to similar hospitals inside Louisiana.

The health-care program for low-income and disabled people is managed on the state level and paid for with state and federal dollars. People enrolled in Mississippi’s Medicaid program are not affected in any way by the River Region decision.

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In a statement, hospital officials call Louisiana’s practices in that regard “insufficient and discriminatory.”

“We have always been able to provide quality health care to our patients regardless of where they live, and we hope we will be able to continue doing so,” River Region CEO Dr. Philip Clendenin said in the statement, sent to northeast Louisiana lawmakers.

Hospital charges are tiered. Insurance companies negotiate discounts and public insurance programs such as Medicaid and Medicare, which serves those 65 and older, pay according to government-set fee schedules regardless of a health-care provider’s charge.

Officials at the hospital on U.S. 61 North, the largest between Monroe, La., and Jackson, are paid “significantly less” than other providers of the same care to Louisiana Medicaid patients because the state permanently fixed reimbursement rates to River Region.

Changes hinge on the fate of a bill authored by Rep. John F. “Andy” Anders, D-Vidalia, which would provide reimbursement to out-of-state providers at in-state rates. River Region said the bill would ensure a “fair and equitable reimbursement rate” for health -care services for such patients.

“We are asking the Louisiana Legislature to respond to the needs of Louisiana residents in communities such as Tallulah, Delta and Lake Providence and take action to ensure they continue to have access to health-care services near their home,” Clendenin said.

The bill is in the House Committee on Health and Welfare. Lawmakers convene June 23.

A spokesman for Gov. Bobby Jindal could not immediately comment.

Letters call Louisiana’s rate “unfair, inequitable and arbitrary” in light of the hospital’s care for the state’s Medicaid patients – a group it totals in the “tens of thousands.”

If changes in the current system do not satisfy River Region, the cutback in services would become the latest on a growing list of changes for the local hospital.

In April, the hospital announced it was seriously considering hiring a group of contract doctors to assist its seven-doctor team of emergency medicine staff. A similar move in 2007 replaced its lone cardiovascular surgeon with a team of physicians employed by Jackson-based Cardiovascular Surgical Group.

Marian Hill, its chemical dependency treatment center, will move from its current spot at the former ParkView Regional Medical Center building on McAuley Drive to the third floor of River Region West on North Frontage Road, hospital officials have said. It is expected to occur by year’s end.

Its parent company, Franklin, Tenn.-based Community Health Systems Inc., is the largest publicly traded operator of hospitals in the United States in the number of facilities and net operating revenues, according to its 2007 first quarter report filed with the Securities and Exchange Commission.

The company generated $2.7 billion in net operating revenues for the quarter ending March 31, with much of it stemming from its acquisition of Triad Hospitals Inc. in July 2007.

As of Dec. 31, CHS sold two former Triad properties and planned to sell six others. The company this year sold nine of its hospitals in Arkansas, Alabama, Oregon and Tennessee to another Franklin, Tenn.-based firm, Capella Healthcare, for about $315 million. Published reports attributed the sale to reducing outstanding debt totaling more than $9 billion.