Growth in MaineCare cited for lagging state payments to hospitals

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AUGUSTA (AP) – The Maine Hospital Association says increased enrollment and service usage within the state Medicaid program known as MaineCare is primarily responsible for what the organization describes as debt owed by the state.

At issue is a Prospective Interim Payment system through which the state pays hospitals for care provided to MaineCare beneficiaries.

The association says weekly PIP payments have failed to keep pace with increased demand for services. As a result, reconciliations after the end of a hospital’s fiscal year between budgeted payments by the state and the actual number of patients served have resulted in substantial gaps, according to the association.

Organization officials said last fall’s agreement with the state was designed to budget an additional $551 million in state and federal money over the next four years to pay hospitals for ongoing MaineCare obligations and cover costs of patient care dating to 2003.

Increased state payments would be meant to reflect current MaineCare patient volume, the hospital association said.

MaineCare is a health insurance program funded jointly by the federal government and the state.

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