River Region pulls plug on La. patients on Medicaid

Published 12:00 am Thursday, November 27, 2008

Unsatisfied with how talks with the State of Louisiana have progressed on reimbursements for serving the state’s Medicaid patients, River Region Medical Center kept a self-imposed deadline Wednesday and announced non-emergency care for Louisiana residents in the program will cease Monday.

In a two-page statement, the hospital reiterated its lawsuit filed against the state to regain estimates of what the facility feels it should have been paid over the past five years.

“We have worked diligently and patiently to resolve this matter with the State of Louisiana in the hopes of continuing to provide high-quality health-care services to Louisiana Medicaid patients who choose River Region Medical Center for their medical needs,” River Region’s interim CEO Brad Holland said.

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“While we are extremely disappointed to be forced into this position, we can no longer provide care for which we are reimbursed at insufficient and unfair rates.”

Patients needing emergency treatment will be accepted. The U.S. 61 North hospital will continue care to Louisiana’s patients enrolled in Medicare, a separate program, and those with private insurance. Also, the Physician Practices of River Region, a complex of outpatient clinics and facilities in Vicksburg, will continue to accept Medicaid and Medicare patients from Louisiana.

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. Over time, the differences have affected River Region’s bottom line. That gap is sure to be felt by patients living in Louisiana’s rural parishes that border the Mississippi River who live closer to acute care hospitals on the Mississippi side than facilities in Monroe and Shreveport — or even south Arkansas.

State lawmakers in Baton Rouge declined to take up a bill during the 2008 legislative session 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-riddled Natchez Regional Medical Center, now up for sale and 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.

The suit is before Judge R. Michael Caldwell of the Baton Rouge-based 19th Judicial District Court.

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

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 will move off McAuley Drive into the third floor of River Region West on North Frontage Road by mid-2009. Also, staff retained at the closed Vicksburg Clinic have moved from the West Campus and merged into The Street Clinic on Grove Street and the outpatient clinics.

Holland was named interim CEO June 25 while a national search is conducted to replace Phillip Clendenin, who resigned, citing a desire to move to his home area in Tennessee.

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.


Contact Danny Barrett Jr. at dbarrett@vicksburgpost.com