Specialty Hospitals of America has sued the District of Columbia for an alleged $24.7 million in Medicaid underpayments over four years, The Washington Post reports.
The hospital company, which operates Specialty Hospital of Washington Capitol Hill and Specialty Hospital of Washington Hadley, maintains the District's failure to fully reimburse its Medicaid treatment costs is putting the hospitals in "imminent financial peril," according to the Post.
The suit, filed with the District's Office of Administrative Hearings, claims the cost of Medicaid care has been improperly based on guidelines for nursing homes rather than intensive care centers, the newspaper reported. Many Medicaid patients are discharged from the city's other hospitals into Specialty hospitals, the company's president and chief operating officer told the Post.
The Specialty hospitals have about 150 beds between them, and according to Michael Barch, chairman of the Health Council of the National Capital Area, provide the only long-term acute care between Richmond and Philadelphia.
Claims of Medicaid underpayments also came from the 39-hospital Maine Hospital Association, which said earlier this year it was owed $484 million in reimbursements. The trade group took out newspaper and radio ads to force action on their claims, arguing the Medicaid underpayments created financial challenges and hurt credit ratings. Maine's governor agreed to a plan to issue revenue bonds paying off $186 million of the Medicaid debt.
The tussles over Medicaid reimbursement come as many states reduce Medicaid reimbursements to hospitals.
To learn more:
- read the Post article