Medicaid Train Wreck Grows Bad Debt at So. Ill. Hospitals
</element><element id="paragraph-1" type="body"><![CDATA[The numbers are staggering and the fears are exponential as Southern Illinois hospitals, clinics, dentists, specialty services and pharmacies dig deeper for a Plan "B" to circumvent another $2.7 billion (with a "B") in proposed state medicaid cuts.
According to the Sparta Community Hospital, which is owed $5.1 million in medicaid payments as of March 31, the turnaround time on claims reimbursements is 221 days. medicaid bad debt is contributing to the growing amount of hospital bad debt all across Southern Illinois. Pharmacies say their turnaround time is somewhat better, averaging 60-90 days.
Everybody's to blame as Illinois public trough runs dry at every level--teachers' pensions, political jobs, teaching, healthcare and universities, once considered a safe harbor. No longer being able to line up at the trough and waiting for payment is the new norm.
Medicaid is a program that provides health care to low-income families, supported jointly by the state and federal governments.
Under current rules, a family of four earning $33,500 annually qualify for free health care for their children. A family of four earning between $33,501 and $67,056 annually pay a small premium each month, usually no more than $80, for child coverage.
There are fewer jobs so more residents try to lie on medicaid applications. Medicaid harbors fraud, inefficiency, unsustainable costs and a paralyzing political climate.
By one account, even the most basic reform - verifying the addresses of Medicaid enrollees to make sure they live in Illinois - has taken more than a year to put in effect because of federal red tape.
The federal Affordable Care Act will expand medicaid eligibility, moving more people to medicaid starting in a state facing $9 billion in unpaid bills, about $2 billion of which are Medicaid-related.
The numbers hit close to home.
Marshall Browning Hospital administrator Ed Gast told the Du Quoin Chamber last week that his hospital does about $5 million a year in medicaid business. The hospital has received only $863,000 in payments since the state's fiscal year began and most hospital administrators in our area say the state has suspended all of its regular payments.
Retiring hospital administrator Bill Huff hit the nail on the head last month. "Everybody wants quality health care, but nobody wants to pay." For Marshall Browning, the sum total of MBH's bad debt is over $7 million in unpaid receivables from the state, state and local employee insurers and private pay patients. Marshall Browning is a not-for-profit hospital and if things don't change could begin defining it.
Pinckneyville Community Hospital administrator Tom Hudgins projected to his board last week that his hospital's net revenue drops to $19,012,944 after subtracting nearly $13 million in estimated bad debt, financial need, insurance discounts and losses through medicare and medicaid.
Healthcare behemoth Southern Illinois Healthcare has $41 million in what it now calls "free" care it gave because of medicaid non-reimbursement.
Hospitals can't dig into reserves forever and the only options are to cut services, find new revenue streams or shift the shortfalls to paying patients.
The number of medicaid enrollees has nearly doubled, to 2.7 million in 2011 from 1.4 million in 2000.
Medicaid applicants are now required to produce a pay stub to show their income level. They do not have to provide identification, like a driver's license. They are asked for a Social Security number, which the state's Department of Healthcare and Family Services uses to try to verify residency.
Those requirements are being tightened this month: Applicants will have to provide one month of pay stubs, and the state will use driver's license records and tax information from the Illinois Department of Revenue to make sure enrollees live in Illinois.