If La. makes Medicaid payments, RRMC cut could jump 63 percent|[05/30/08]

Published 12:00 am Friday, May 30, 2008

Payments to River Region Medical Center by the State of Louisiana for treating its Medicaid patients could jump 63 percent if provisions of a pending bill are enacted, a study prepared for the state’s lawmakers reveals.

Medicaid reimbursements to the hospital would exceed more than $1.4 million if Louisiana lawmakers agree to increase payments to out-of-state providers. Currently, RRMC is paid about $882,000 for what recent patient case-loads have averaged since 1999.

Earlier this month, hospital officials sent letters to Louisiana Medicaid patients notifying them River Region-maintained medical facilities in Vicksburg might discontinue non-emergency care to those patients by July 1 because reimbursement rates have remained 50 percent less than the rate paid to similar hospitals inside Louisiana.

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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.

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

Legislation authored by Rep. John F. “Andy” Anders, D-Vidalia, would provide reimbursement to out-of-state providers at in-state rates for hospitals with at least 1,000 inpatient days in 2007. River Region has said the bill would ensure a “fair and equitable reimbursement rate” for health-care services for such patients. The bill is in the House Committee on Health and Welfare. Lawmakers are in session through June 23.

Two other hospitals, Natchez Regional Medical Center and Natchez Community Hospital, stand to receive more money from treating patients from just across the Mississippi River. The Adams County-owned regional hospital, cleared by Mississippi lawmakers for bankruptcy due to being $4.5 million in debt, has averaged the highest Medicaid-related patient load, based on estimates in the report prepared by the Legislative Fiscal Officer. Payments there would increase by $103.27 per Medicaid day if the law passes.

If cutbacks in services are enacted, it would join other planned and possible changes at River Region, Warren County’s only hospital.

Contract doctors might join its emergency staff, similar to those outsourced to assist cardiovascular physicians there and at several Jackson hospitals. Its chemical dependency center, Marian Hill, is expected to move to River Region West on North Frontage Road within a year.

Also, it would complete a shift in Louisiana’s Department of Health and Hospitals’ policy regarding Medicaid. In 1999, a legislative act enabled DHH to restrict payments to out-of-state hospitals providing services to the state’s Medicaid patients. It concluded previous belt-tightening begun earlier in the Foster administration when current Gov. Bobby Jindal served as DHH secretary. Under Jindal’s directorship, the state’s Medicaid program went from a $400 million deficit to a $220 million surplus.