LEWISTON — About 700 St. Mary's Regional Health Care patients are facing unexpected bills for annual physicals that used to cost them little or nothing.
Earlier this year, St. Mary's changed 12 primary care and family practices from federally qualified health centers to departments of the hospital. The change gave the hospital greater control over the medical practices, the hospital board's could oversee the doctors' offices and St. Mary's could link everyone through its computer system.
But it created an unexpected consequence for some patients. When their doctors' offices were health centers, the federal government paid for the annual physicals of qualified patients. When the offices became departments of the hospital, dropping the health center designation, the federal program that paid for the physicals no longer applied.
Patients who qualified for the free or low-cost physicals also qualified for Medicare, but Medicare does not cover annual physicals. About 700 patients found themselves facing an average $336 bill for the exam.
Hundreds of patients were billed before St. Mary's realized there was a problem.
"Where there are so many pieces we had to get in place with the transition ... it took us a while to react to getting a communication put together for patients," said Doug Miller, St. Mary's operations director for doctors' offices.
Recently, the hospital sent a one-page letter to 93 patients with upcoming appointments, advising them that they would have to pay for the exam out of pocket and offering to cut the exam's cost in half. The cost has also been cut in half for the hundreds of patients who had their exams earlier this year.
Beginning in January, Medicare will cover annual exams and other preventive care under the new health care reform rules.