Patients File Complaint Against Madera Community Hospital Over Decision to Drop Medi-Cal Contract
Two Madera women have filed a complaint with the federal Office for Civil Rights in San Francisco over Madera Community Hospital's decision last month not to renew a contract with Medi-Cal, "claiming that the move is unfair to low-income patients," the Fresno Bee reports. Madera Community decided not to renew the Medi-Cal contract after hospital representatives failed to reach an agreement with state officials on reimbursement rates (Leedy, Fresno Bee, 12/5). The hospital had sought a 25% increase in reimbursement rates (California Healthline, 11/21). The women, represented by California Rural Legal Assistance Inc., have accused the hospital of "treating Medi-Cal beneficiaries differently than other patients," a violation of the state's Hill-Burton Act. The law requires hospitals that receive federal funds during construction to "arrange for Medi-Cal reimbursement." Although Madera Community will still treat Medi-Cal patients for outpatient and emergency procedures, the hospital will transfer inpatients to other facilities. Medi-Cal will reimburse the hospital for emergency care on a "per-case basis." Madera Community CEO Robert Kelley said, "We have an agreement with Medi-Cal, it's just not contracted." The regional OCR will study the complaint and decide whether to investigate the hospital (Fresno Bee, 12/5).