Coast hospitals suing MS Medicaid Division to recoup costs

Coast hospitals suing MS Medicaid Division to recoup costs

GULFPORT, MS (WLOX) - Two large Coast hospital systems are ready to go to court to fight for what they claim are $20 million in under-funded Medicaid reimbursements.

Memorial Hospital at Gulfport says it was shorted more than $10 million by the Mississippi Division of Medicaid during the past fiscal year. Singing River Health System also claims it's owed more than $6 million in reimbursements.

On Wednesday, the hospitals filed a joint lawsuit against the agency, seeking to recover what they call "underpaid Medicaid funds".

"This money is available in the state of Mississippi. It is not a state budget issue. It's in the general fund for the Division of Medicaid, a sufficient amount to get these two Coast hospitals their cost back. That hasn't happened and we're asking the court to find out why," said Memorial Hospital President/CEO Gary Marchand.

Both hospital executives say a new state law enacted in March 2015 sets new criteria to make sure Medicaid patients and the uninsured have access to medical care. However, they also say the funding formula is flawed.

"We felt we have exhausted all of our resources to try to resolve this in as many ways as we possibly could," said Singing River Health System CEO Kevin Holland. "So this is certainly a last resort for us."

While their facilities are being underfunded, the executives believe other hospitals, mainly in the Pine Belt, are getting excess money - as much as $35 million.

"Our costs aren't being covered and we're watching other hospitals getting windfall payments. It's unfair, inequitable. I'm frustrated," added Marchand.

Harrison County ranks second and Jackson County is fourth in the state in the number of uninsured patients. Hospital executives warn that if their systems can't recoup costs, certain health services could be in jeopardy.

"We're looking at mental health service availability, what uninsured services might be taken out of the budget. We cannot go year to year to year being underpaid $10 million without it impacting our ability to provide care in some way," said Marchand.

Mississippi's Division of Medicaid Executive Director Dr. David J. Dzielak sent WLOX News Now the following statement:

"Medicaid is a key component to health-care access across the state. The agency follows state law and federal regulations set forth in the State Plan, which is approved by the Centers for Medicare and Medicaid Services."

Copyright 2016 WLOX. All rights reserved.