Madera Community Hospital Signs Medi-Cal Contract After Three Years
Madera Community Hospital has signed a contract with the state to begin providing nonemergency services to Medi-Cal beneficiaries, the Fresno Bee reports. In November 2001, Madera Community officials chose not to renew the hospital's Medi-Cal contract, forcing beneficiaries in need of nonemergency services to seek treatment at a hospital with a Medi-Cal contract within a 30-mile radius (Correa, Fresno Bee, 8/5). Madera Community dropped the Medi-Cal contract after hospital representatives could not reach an agreement with state officials on reimbursement rates. The hospital had sought a 25% increase in reimbursement rates. In May 2002, three Madera women, represented by California Rural Legal Assistance, filed a lawsuit against the hospital over its decision to drop the Medi-Cal contract, alleging that the move led to "illegal policies." The lawsuit, filed in Madera County Superior Court, accused the hospital of "treating Medi-Cal beneficiaries differently than other patients," a violation of the state's Hill-Burton Act, which requires hospitals that receive federal funds during construction to contract with Medi-Cal. The lawsuit, which sought unspecified monetary damages, also alleged that the hospital violated other laws by "telling Medi-Cal patients they must be transferred" to other facilities for elective surgeries (California Healthline, 5/3/2002). CRLA last week announced that it is dropping the lawsuit.
Madera Community began to admit Medi-Cal beneficiaries last month. Robert Kelley, CEO of Madera Community, said he "[could not] say the reimbursement amount" that the hospital negotiated with the state because Medi-Cal reimbursement contracts are confidential. However, he said that the facility had qualified for supplemental payments "in the neighborhood of $1 million" through the disproportionate share program. Under the program, hospitals that meet a minimum threshold of indigent care volume qualify for federal assistance. Kelley said that the hospital likely could not have renewed the Medi-Cal contract without the disproportionate share payments (Fresno Bee, 8/5).
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