Settlement Near In Idaho Lawsuit To Reduce Medicaid Write-Offs
A lawsuit against the state to reduce Medicaid write-offs at Idaho hospitals by $6 million to $10 million a year could be close to resolution, a Moscow hospital administrator says.
Gritman Medical Center Administrator Bob Colvin is a member of the Idaho Hospital Association’s board of directors, which filed a federal lawsuit in December against what it considers an outdated Medicaid reimbursement schedule.
The suit contends Medicaid schedules adopted in 1987 are based on cost assessments compiled a decade ago, and have not been adjusted to reflect inflation or the surging cost of treatment.
In 1991, the Idaho Hospital Association estimates its members wrote off or otherwise apportioned more than $6 million in Medicaid losses.
Colvin said he believes that figure doubled in 1994 to nearly $12 million.
“I advocated suing the state because the payment mechanisms just continue to deteriorate,” Colvin said. “Every time the state or federal government takes a portion of the program away, the local community suffers.”
The rest of the community, people with private insurance or people who pay cash, are subsidizing the local costs of Medicaid, as well as funding it through taxes, he said.
“The state is leaning toward a settlement,” Colvin said. “We’re very optimistic at this point that something will be decided in our favor within the next 60 days.”
The association’s move is part of a larger effort by doctors and hospitals nationwide who refuse to accept dwindling reimbursements for ever more costly procedures.
A key point for the Idaho Hospital Association is the federal Medicaid regulation that requires states to pay hospital reimbursements that are reasonable and adequate to meet costs of treating poor people. The suit contends those reimbursements are nowhere near that level.
While outpatient services are a large part of the underfunded reimbursements, this suit requires the state to update inpatient schedules only, and it is not retroactive.
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