A Mississippi Hospital Association analysis of Medicaidproposals indicates many health care facilities would fare betterunder a failed House plan as opposed to one scheduled to beimplemented by Gov. Haley Barbour next month.

After the governor and state lawmakers failed to agree on asolution to close a $90 million funding gap for Medicaid, Barbourunveiled his plan that he says does not need legislative approval.It is scheduled to be implemented Sept. 1, but a legal challengecould delay its enactment.

The hospital association’s comparison claims 87 hospitals willdo worse under the governor’s plan as opposed to the failed,MHA-backed House Bill 24, while only 22 will see improvement. Thestudy shows the net financial gains and losses between the twoplans.

Barbour’s plan calls for increases in hospital assessments andchanges in the way they are reimbursed for providing services toMedicaid patients. The failed hybrid House bill included acombination of a tobacco tax increase and a bed tax.

According the MHA document, local hospitals all lose under thegovernor’s plan and would have all benefited under the Houseplan.

The asssociation’s comparison shows King’s Daughters MedicalCenter losing approximately $1.4 million; Lawrence County Hospitallosing $302,000; and Franklin County Memorial Hospital losing$490,000. Had HB 24 been enacted, the comparison claims it wouldhave resulted in a $1.2 million gain for KDMC; a $509,000 gain forLCH; and a $325,000 gain for FCMH.

MHA Vice President of Finance/Chief Financial Officer MikeBailey contended the association’s comparison was necessary toprovide some foundation for the governor’s plan, which included alegally mandated economic impact study for hospitals that theassociation found unsatisfactory.

“The study is qualified in my opinion, but the data sets used inthe measurements are not valid,” he said. “They’re leaving a veryimportant parameter out of this – the cost of the hospitalproviding the service.”

Bailey said the governor’s plan’s accompanying economic impactstudy more or less measures itself against itself, deciding whichhospitals are winners and losers based on whether they pay more orreceive more from Medicaid.

“Let’s say you work for a company that pays you $100,000 peryear, but levies a $90,000 tax on each employee,” Bailey said inoffering an illustration. “Even though you’re only coming out with$10,000 per year, they think you’re OK, and that’s what Medicaid isdoing. The study doesn’t draw the correct picture. All it says isMedicaid pays hospitals more than hospitals pay Medicaid, and thatmay be good or it may not.”

Bailey said the study accompanying the governor’s proposal alsofails to take into account bed taxes already paid by hospitals.And, due to the proposal’s stipulation that Medicaid reimbursementsbe distributed through UPL (Upper Payment Limit) payments in masssums to the three hospital classifications rather than toindividual hospitals, Bailey said some hospitals are actuallyhaving to pay Medicaid to treat Medicaid patients.

“That’s worse than just losing money, they’re paying money,” hesaid.

Under the governor’s plan, Bailey said while some hospitals willsuffer reimbursement losses that will cripple their ability tooperate, others will receive “egregiously high” reimbursements.

“There seems to be no standard within their methodology, and theequity is not there,” he said.

Bailey said many of the association’s member administrators havecalled his office complaining about the governor’s proposal andseeking help. He said the association is not discounting its legaloptions to stop the proposal from going into effect.

“If the governor is successful in implementing this plan onSept. 1, there will be hospitals in Mississippi that will closebefore the end of the year,” Bailey said.

District 92 Rep. Becky Currie, R-Brookhaven, still maintainsthat Senate Bill 2013 – the legislation containing a $167 per daybed assessment as a means of funding Medicaid – would have been thebest, most fair solution to the division’s funding dilemma. Shesaid she joined other House Republicans to block HB 24 on Aug. 4 inthe hopes of forcing SB 2013 to the House floor.

“The hospital association hired the guru to come in to write SB2013,” Currie said. “My question to them is why did they desert it?If we would have had SB 2013, we wouldn’t be in this mess.”

Area hospital administrators offered their support for SB 2013,but they also acknowledged the merits of a tobacco taxincrease.

Currie, who has worked in the medical field all her life, isdisappointed in MHA for supporting SB 2013 while simultaneouslycalling for increased tobacco taxes. She believes the association’sduality on the matter helped foster the erosion of support for thebill.

Currie said she has no problem with increasing the state’stobacco taxes – she aligned with House Democrats and voted to do sotwice in the regular session – but doesn’t believe the taxes willbe sufficient to fund Medicaid.

“The governor wants a long-term solution to Medicaid becauseevery year Medicaid is a fight,” she said. “Tobacco taxes have beenpresented as a solution in the House 19 times over the last fewyears, and I’m tired of hearing that it’s the only way we can solveproblems – it’s a decreasing revenue. Some of the money could go toMedicaid, but it’s not a long-term answer.”

However wary Currie is about depending on tobacco taxes to shoreup Medicaid, she is even more concerned with the governor’sproposal. She, along with numerous other hospital and legislativeofficials, feel that a lawsuit filed against the governor byhospitals will come within the next two weeks.

“I can assure you before the plan goes into effect on Sept. 1that a suit will be filed so they can stop it until a judge rules,”Currie said. “My hopes are when the lawsuit – which both of myhospitals (KDMC and FCMH) are participating in – the judge takes aslong as he did with the last ruling. Then we’ll be back in sessionbefore there’s a decision so we can fix this problem.”