Monday, August 3, 2009

Editorial: Hospital expenses burning hole in St. Lucie County's jail budget

Hospitals shouldn't be allowed to charge more than they receive through Medicaid.

If an inmate in the St. Lucie County Jail requires hospital treatment, who pays the bill? If you're a county taxpayer, you do.

St. Lucie County commissioners recognize that obligation. But, they're lobbying the state to get a better deal on the cost than they — and taxpayers — have now.

Under existing regulations, each county must negotiate a contract with a hospital or hospitals they want to care for their inmates. The contracts take into account the services provided compared with transportation and security costs.

Most inmates at the St. Lucie jail are treated at Lawnwood Regional Medical Center & Heart Institute. Under a contract, the county (taxpayers) pay 65 percent of the fees. The hospital absorbs the rest.

Neighboring counties have better deals with their hospitals. Martin County pays 45 percent of the costs at Martin Memorial Health Systems. Indian River County generally pays 34 percent through the Indian River Medical Center.

That 34 percent is the typical rate hospitals receive for treating patients on Medicaid.

St. Lucie County wants state regulations to require that all hospitals charge counties the Medicaid rate. In the meantime, county officials ought to do a better job negotiating.

Last year, St. Lucie County paid more than $1.6 million in inmate hospital medical care. That's money that could have been spent elsewhere.

Had the county been charged the Medicaid rate, taxpayers would have saved $250,000.

St. Lucie is lobbying through the Florida Association of Counties to make the Medicaid rate uniform throughout the state. It seems unreasonable for hospitals to charge counties differing amounts, depending on what rates are negotiated between the hospitals and the counties.

And, since St. Lucie taxpayers are being forced to pay more — not only in rates, but because of the number of inmates compared to neighboring counties — that, also, seems unreasonable.

Changes should be made so that inmates can still get the treatments they need at the nearest hospital and so taxpayers, such as those in St. Lucie, are not stuck with higher bills than Medicaid pays.


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