Providers, state regulator at odds over hospital margins

Maine's hospitals and a state agency are at odds over determining profit margins for inpatient facilities--a potentially complicating factor in deciding how much money is owed to providers under the state's Medicaid program, reported the Bangor Daily News.

The Maine Hospital Association has claimed an overall profit margin for its hospitals of about 2 percent. But data submitted by the hospitals to the Maine Health Data organizations put the margins at around 3.7 percent.

The two groups' data apparently differs based on the methodology used to arrive at their numbers, according to the Daily News, but the reason for the discrepancies still remains unclear.

The relative financial health of hospitals in Maine is crucial to an ongoing debate regarding MaineCare, the state's Medicaid program. The hospitals maintain they are owed about $484 million in Medicaid payments from the state dating back to 2009. Lawmakers have struggled to determine the best course for reimbursing the hospitals.

Partly as a result of the financial pressures hitting Maine's providers, Gov. Paul LePage, a Republican, has asked the Obama Administration for a decade of full funding of Medicaid expansion that would add about 55,000 residents to the MaineCare rolls, according to the Morning Sentinel.

In the meantime, Maine state Sen. Geoff Gratwick plans to introduce legislation that would make a specific state agency or entity entirely responsible for accurately gauging hospital financial data. Gratwick called the 990 forms hospitals submitted to the Internal Revenue Service a "sham," , according to the Daily News.

To learn more:
- read the Bangor Daily News article
- read the Morning Sentinel article

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