Memorial Hospital at Gulfport and Singing River Health System (SRHS) have filed a second lawsuit in Hinds County Chancery Court following a denial of their appeal to the Division of Medicaid (DOM) regarding underpayments that occurred in State Fiscal Year (SFY) 2014. The lawsuit claims that DOM has a payment methodology that is contrary to state law. The lawsuit seeks recovery of the underpayments and legal fees. Harrison County has the second highest population of uninsured residents in the state (approximately 35,000) and Jackson County has the fourth highest population of uninsured residents in the state (approximately 25,000).
Memorial and SRHS are both public, not-for-profit health systems that serve as safety net providers for their communities and deliver critically needed care to all residents. The hospitals filed suit against DOM in late June for underpayments related to SFY 2016. Two days later, the hospitals were notified that their appeal for underpayments in SFY 2014 was denied. An appeal within the DOM for SFY 2015 underpayments remains outstanding. The outcome of this lawsuit will resolve underpayments for services provided to Medicaid beneficiaries and uninsured patients in 2014 and 2015.
“With recent actions taken by the Division of Medicaid to deny payments, coupled with a recently announced plan to phase in any further payment adjustments over a 10-year period, important services are now at risk. For Memorial, the key services are mental health and access to primary care for the uninsured,” said Gary G. Marchand, President and Chief Executive Officer of Memorial Hospital.
“It is critical that hospitals such as Singing River and Memorial are appropriately funded for the level of uninsured and underinsured services that we provide to our communities. We are optimistic that our challenges to the current funding methodology will help redistribute these statewide funds to the places that are delivering the highest levels of uninsured and underinsured care in our state,” Kevin Holland, Chief Executive Officer for SRHS, commented.
SRHS reports total underpayments of $21 million since the Division began underpaying for services provided to Medicaid beneficiaries and the uninsured. Memorial reported that underpayments have totaled $25 million.
BEFORE YOU GO…
… we’d like to ask for your support. More people are reading the Mississippi Business Journal than ever before, but advertising revenues for all conventional media are falling fast. Unlike many, we do not use a pay wall, because we want to continue providing Mississippi’s most comprehensive business news each and every day. But that takes time, money and hard work. We do it because it is important to us … and equally important to you, if you value the flow of trustworthy news and information which have always kept America strong and free for more than 200 years.
If those who read our content will help fund it, we can continue to bring you the very best in news and information. Please consider joining us as a valued member, or if you prefer, make a one-time contribution.Click for more info