The Citrus County Hospital Board, owner of Citrus Memorial Hospital in Inverness, Fla., is recouping an additional $1.3 million it says CMS owes for years old Medicaid services, according to the Chronicle.
The recoupment comes after the hospital joined Tampa-based HCA West Florida in 2014 under a 50-year lease. HCA West Florida is a division of Nashville, Tenn.-based for-profit hospital operator HCA Healthcare.
Hospital board attorney Bill Grant said when the board leased the facility to HCA, it set up a fund for claims that may be made by third-party insurance payers.
But as claims came in, the board discovered that the previous operator, what is now the Foundation Resolution Corp., had not registered the hospital as a disproportionate share hospital, a federal designation to hospitals that serve a disproportionate share of low-income patients, according to the Chronicle. The payments help these hospitals cover the costs of caring for indigent patients and provide an increased reimbursement rate.
The newspaper reported that the hospital board was not able to petition for the lost money due to the amount of time since HCA took over the lease. But Mr. Grant said when the Florida Agency for Health Care Administration did an audit, it allowed the board to reopen several billing years for review.
"We opened them back up and redid the numbers and found they [the previous tenant that leased the hospital before HCA] had underreported significantly the DSH monies," he said.
He said the board was able to recoup $1.2 million from CMS in underpaid Medicaid payments from fiscal year 2012-13 earlier this year and is also waiting on the disbursement of an additional $1.3 million authorized from fiscal year 2013-14.
He said board members want to review other years of Medicaid reimbursement, as far back as fiscal year 2005-06, and estimated the board could recoup an additional $5 million to $15 million.
CMS declined to comment on the matter.
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