Leaders of several Mississippi nonprofit hospitals say a complex and unfair Medicaid reimbursement formula has left their facilities struggling to survive, while county hospitals reap multimillion-dollar reimbursement windfalls.
The Upper Payment Limit and Disproportionate Share Hospital payment programs are designed to make up for gaps Medicaid doesn’t cover.
Hospitals are put in three categories: state, county and private. Each category gets a portion of extra Medicaid money, and under the formula, a number of county hospitals ended up splitting a huge amount of money.
Medicaid regularly reimburses hospitals for medical care for the poor.
Daryl Weaver, chief executive for King’s Daughters Hospital in Yazoo City, a private nonprofit hospital, said the formula is really hurting his facility. The hospital got only $442,104 when its uninsured care costs ran nearly $1.1 million last year.