River Region Medical Center has taken its disagreements with the State of Louisiana over how it is reimbursed for non-emergency care of the state’s Medicaid patients to court and announced no Medicaid patients from Mississippi’s neighboring state will be accepted after Dec. 1.

In a suit filed in the Baton Rouge-based 19th Judicial District Court, the hospital seeks to recover cost differences between what it said it should have been paid during the last five years for extended care to patients insured by the federal-state program and what Louisiana actually paid, according to a release from the U.S. 61 North facility this morning.

Judge R. Michael Caldwell will hear the case, hospital spokesman Diane Gawronski said.

Differences have existed for nearly a decade between what Louisiana pays to Mississippi hospitals and what it pays its in-state health-care providers.

The gap is felt in Vicksburg especially, because the acute care hospital here is closer to residents of Madison, East Carroll and Tensas parishes than any large Louisiana hospital. Patients turned away here would likely go to Monroe or Shreveport or medical facilities in South Arkansas.

Patients needing emergency treatment would still be accepted. No announcement was made regarding whether Louisiana Medicaid clients would be treated at the many River Region outpatient clinics and facilities in Vicksburg.

Created in 1965, Medicaid now serves one in four Mississippians who are deemed low-income or disabled and half of all children. The ratio for Louisiana is lower, but precise figures were not available.

Medicaid is administered by state health agencies and paid for with state and federal dollars. Discounts are negotiated by insurance companies, and payments are made according to government-set fee schedules regardless of the health-care provider’s charge.

The Louisiana Department of Health and Hospitals limited payments to out-of-state providers in 1999, when the agency was headed by current Gov. Bobby Jindal.

State lawmakers in Baton Rouge declined to take up a bill that would have made higher payments to out-of-state hospitals with at least 1,000 inpatient days in 2007. Instead, the Secretary of State’s Office agreed to further study the matter.

Studies completed by the Legislative fiscal officer during the session showed annual payments to three Mississippi hospitals fitting the criteria would increase dramatically if payments were equalized. Payment totals to River Region would have increased to more than $1.4 million, 63 percent more than what it is now paid. Payments to debt-strapped Natchez Regional Medical Center, the facility with the highest Louisiana Medicaid patient load in Mississippi, would increase $103.27 per Medicaid day under the deferred bill’s provisions. Natchez Community Hospital would recoup nearly $1,000 more per Medicaid day.

According to the legislative study, the difference between the current payout and what would be paid if the bill had passed would equal about $2.9 million.

Brad Holland, the hospital’s interim CEO, said efforts to work with the state’s lawmakers on the local and federal level were laudable but still fell short of achieving equitable reimbursement. 

“Throughout 2008, we have made it clear that it is our strong desire to continue providing care to the many Louisiana Medicaid patients who have made us their hospital of choice, and on their behalf we have worked very hard to encourage a positive resolution,” Holland said. “We applaud the leadership of U.S. Rep. Rodney Alexander, state Rep. Andy Anders and state Sen. Francis Thompson for their efforts to preserve RRMC as a convenient health-care option for their constituents such as Tallulah, Delta and Lake Providence and across northeast Louisiana.”

River Region’s patient base beyond Warren County includes Claiborne, Issaquena, Sharkey and Yazoo counties, plus western Hinds County. Its Louisiana patients have come from the river parishes of East Carroll, Madison and Tensas, with some as far west as Delhi.

Changes at Warren County’s lone hospital have been steady since its former corporate parent, Triad Hospitals, merged with current parent Community Health Systems, in 2007.

Physician teams have replaced on-staff cardiovascular surgeons with the hospital considering the same as a supplement to its emergency room doctors. Staff at its Marian Hill chemical dependency unit have moved off McAuley Drive into the third floor of River Region West on North Frontage Road.  Also, staff retained at soon-to-close Vicksburg Clinic are moving from the West Campus and merging into The Street Clinic on Grove Street.

Holland was named CEO June 25 on a temporary basis as a national search is conducted to replace Phillip Clendenin, who announced his resignation.

Located in the Nashville, Tenn., suburb of Franklin, Community Health Systems Inc. is the largest publicly traded hospital company in the United States. It owns, leases or operates 118 hospitals in 29 states, largely in small and mid-sized markets.

CHS closed Wednesday on a deal to acquire Spokane, Wash.-based Empire Health Services. The acquisition deal calls for CHS to spend at least $40 million on routine capital expenditures within five years of acquiring the two hospitals and $60 million in capital improvements.