Supporters take case for reimbursement to legislators

If there is any truth to the adage of strength in numbers, Critical Access Hospitals should be applauding their accomplishments.

Franklin Hospital was among the CAH facilities that stood in support of two bills that would bring more money to rural healthcare hospitals.

CEO Hervey Davis said 100 people from 10 Critical Access Hospitals listened during two hearings held in Springfield as legislators push for reimbursement for Medicaid costs.

"Sen. Gary Forby did a great job on the senate floor," Davis said. "Both he and Rep. John Bradley strongly support the legislation. There were 14 or 15 co-sponsors of Senate Bill 3264 by the time it went to the House of Representatives committee. The bill has support from Republicans and Democrats alike. There were seven co-sponsors of the Senate Bill and 15 co-sponsors of House Bill 5765. There was only one opposition from Health and Family Services formerly known as Public Aid. There was no opposition in the House committee."

Davis said that should the bills obtain congressional approval there is still plenty of work to be done.

"The U.S. Centers for Medicare and Medicaid Services has a provision that allows Critical Access Hospitals to be reimbursed at cost for Medicaid claims," he said. "Illinois CAHs receive, on average, about 41 percent of Medicaid costs, without the Hospital Assessment Program.

"If both bills are approved, they will go to Gov. Pat Quinn for his signature," Davis said. "But the celebrating does not begin when the ink dries. He would still have to appropriate the money into the next fiscal year's budget. The state would have to pop for $12 million. The federal government would have to come up with $18 million. If approved, Franklin Hospital would receive an additional $1.1 million in Medicaid reimbursement costs. This would be a once a year payment."

He said Critical Access Hospitals provide care to 40 percent of the state's population.

"Medicaid pays the CAHs in a number of different ways," Davis said. We receive 10 cents on the dollar for Medicaid reimbursement costs but it costs the hospital 50 cents on the dollar to provide services. Reimbursing CAHs for their outpatient Medicaid claims would require a relatively small amount of additional state funds, an estimated $12 million, and would strengthen the health care safety net in rural areas of the state."

"Sen. Forby is very effective," he said. "He has done more for this hospital than any other legislator that I have been involved with in my 30 years in health care. He is respected by his peers, he knows who to talk to and he gets the job done."

Davis said the Senate and House committees are comprised of urban and inner-city folks who know very little about rural health care.

"When the bills go to the full Senate and House, I expect I will be making another trip to Springfield," he said. "I will probably go and talk to the governor and his staff myself.

"The Illinois Hospital Association arranged a meeting with Michael Gelder, who is the governor's liaison for health care affairs. Gelder was very receptive. Now, it is a matter of looking for ways so the governor can make this happen.

"The hospital's annual expenses amounted to $14 million in 2009," Davis said. "The hospital has less than 20 days cash on hand. That is a fact throughout all 10 area CAHs. We pay almost $7 million in payroll and benefits.

"Sen. Forby put it into perspective that even legislators from northern Illinois could understand," he said. "He said if the 10 CAHs were taken away, it would have a negative impact on the state. That would cost about $140 million in revenue because all of those jobs would be lost Putting it on a local level, Forby told legislators that the new Sugar Camp Energy mine going in near Akin would not have been a reality without access to critical emergency care."

Davis said it is equally important to send postcards to Sen. Forby and Rep. Bradley for supporting SB3264 and HB5765.

"I urge residents to write to their legislators, thanking them for supporting the bills," he said. "It is also important to send a postcard to the governor urging his support of the bills."

Addresses for legislators may be found on page 4 of today's newspaper.

Forby said the bills would have a large impact on local hospitals.

"This is an important step to ensure these critical access hospitals can continue operating efficiently and get reimbursed for their services," he said. "This will especially have a large impact on some of the local hospitals in our district like Franklin, Eldorado, Anna, and Hardin and Hamilton counties. Critical Access Hospitals are an important part of our Southern Illinois communities because they employ so many people and provide vita services to such a large area."