Hospitals say the state owes them $90 million.
By Donna M. Perry
Staff Writer

Hospital officials claim they are owed $90 million for services provided in the MaineCare program in past years.

With more proposed cuts looming and up to 75,000 more people poised to join the MaineCare program in July, health care providers are worried about the viability of the system.

Total cuts to hospitals in the governor’s two-year budget equal $109 million, they say.

However, state officials claim the governor’s proposed budget addresses owed MaineCare settlements. Trish Riley of the Governor’s Office of Health Policy and Finance said hospitals will be $50 million in the black if the proposed budget is approved.

She also said the state is asking everybody to share in the pain of balancing the budget.

As of Jan. 1, nearly 241,000 people were covered under the MaineCare program. MaineCare, formerly known as Medicaid, is health insurance for low- and moderate-income people funded federally $2 to every $1 from Maine.

The Maine Hospital Association claims MaineCare owes hospitals statewide about $90 million for previous years of services rendered to MaineCare patients, said association spokeswoman Mary Mayhew.

However, Riley said the state itself doesn’t owe that much.

The state owes roughly $30 million and the federal government owes roughly $60 million because of the way the program is funded, said state spokesman Newell Augur.

A quick survey of what area hospitals are owed for care to MaineCare patients:

• Maine Medical Center in Portland: $22.6 million for services to date, said hospital spokesperson Wayne Clark.

• Central Maine Medical Center in Lewiston: an estimated $7 million in the last couple years, said Guy Orne, chief financial officer. “We’re growing concerned that we’re never going to see the money,” Orne said. Orne estimates the state will owe the hospital another $2 million at the end of this year.

• St. Mary’s Regional Medical Center in Lewiston: $6.8 million as of the close of 2003, with the lion’s share over a two-year period, said Sean Findlen, manager of community relations.

• Franklin Memorial Hospital in Farmington: $6 million, said Richard Batt, president of Franklin Memorial Hospital.

• Stephens Memorial Hospital in Norway: $1.5 million covering a two-year period from Oct. 1, 2001, to Sept. 30, 2003.

• Rumford Hospital: an estimated $1 million for 2002 and 2003, and Orne estimates that the state would owe another $800,000 by the end of the year.

• Bridgton Hospital: an estimated $300,000 in 2003, Orne said. He estimates it would be $600,000 by the end of the year.

The amount owed is growing every day, Batt said.

The state is expanding the MaineCare rolls and underfunding hospitals for the services they provide, said Steven Michaud of the Maine Hospital Association.

“We’re seeing a lot more patients than the state anticipated and budgeted for,” Michaud said.

Hospitals receive periodic interim payments. The payment amounts were estimated years ago based on what the state would owe hospitals for caring for MaineCare patients, Batt said.

“It’s a lot of money, and we’d like to have it,” said Tracey Geary, director of development at Stephens Memorial Hospital.

A fact sheet from the Norway hospital claims that in 2001 the national average for reimbursement by Medicaid was 98 percent of costs.

Maine’s rate was 81 percent.

Under the current budget, the reimbursement rate for MaineCare services is 73 percent of costs; with the governor’s proposed cuts, MaineCare services would be reimbursed at only 67 percent of the cost to provide service, the hospital noted.

“No one likes the cuts being proposed to Medicaid,” said Tammy Greaton, co-director of Maine People’s Alliance, a 22,000 member nonprofit citizen action organization.

“All health-care providers are taking hits in Medicaid and many have cooperated in figuring out how to save money in the least damaging way. Hospitals, on the other hand, are taking a ‘just say no’ approach and could do more to contribute to the solution.”

dperry@sunjournal.com

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