Riverside Hospital Loses Insurance Contracts After Being Dropped from Medicare and Medi-Cal
Parkview Community Hospital in Riverside lost most of its contracts with health insurers after it was dropped from Medicare and Medi-Cal earlier this month, and it may not be able to restore those agreements for up to six months even though government funding has been conditionally returned, the Riverside Press-Enterprise reports. Until the contracts are restored, Parkview may have to curtail services and furlough employees. Norm Martin, the hospital's CEO, said that "nearly all" of Parkview's health insurers canceled their contracts after federal and state inspectors dropped the hospital from Medicare and Medi-Cal earlier this month, citing problems involving nursing and pharmacy services, quality assurance and medical staffing that were placing patients' health in "imminent jeopardy." Medicare and Medi-Cal beneficiaries make up 66% of Parkview's patients and account for almost half of the facility's revenue (Beeman, Riverside Press-Enterprise, 3/15). The government funding was conditionally restored on March 12 when state and federal officials said that Parkview had "corrected the worst of the problems." The hospital also received a preliminary denial of accreditation from the Joint Commission on Accreditation of Healthcare Organizations that began Feb. 8 and ended March 12, when the hospital received conditional accreditation status (California Healthline, 3/14). While Vern Hall, chair of the hospital's board, said that Parkview "is not going away," he added that it may take "months to a year" before the facility "return[s] to normal." As of last Thursday, the 193-bed hospital had 21 patients and did not plan to reopen its emergency room "anytime soon." Martin said that as Parkview reinstates the insurance contracts, it will try to negotiate higher reimbursement rates from health insurers. Several large medical groups said they will resume utilizing services at Parkview when insurance contracts are in place and "physicians and patients want to go there," the Press-Enterprise reports (Riverside Press-Enterprise, 3/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.