Florida hospital recoups contested Medicaid payments

Citrus Memorial Hospital in Inverness, Fla., has recouped $2.65 million in Medicaid payments after a battle with CMS, according to the Citrus County Chronicle.

The hospital is operated by Nashville, Tenn.-based HCA Healthcare, but the Medicaid payments at the center of the dispute date back to before HCA began leasing the hospital in 2014.

The group that operated Citrus Memorial Hospital prior to the HCA lease failed to register it as a disproportionate share hospital, a designation that provides a higher reimbursement rate for hospitals that treat a disproportionally high number of indigent patients. This resulted in the hospital being underpaid by Medicaid during 2013 and 2014.

The hospital board filed a petition seeking payment for the Medicaid cases it was underpaid for when the Florida Agency for Health Care Administration audited the hospitals payments for the past several years, according to the report.  

The Florida AHCA said the audit revealed the hospital had received $5.8 million in Medicaid overpayments between 2006 and 2016, and that the agency would recoup the money from future Medicaid payments. In response, lawyers representing Citrus Memorial claimed that the hospital was underpaid by Medicaid in 2013, 2014 and likely several other years.

Under a recent agreement between CMS and the hospital board, the hospital recouped the $2.65 million in contested payments. The agreement also halts CMS from seeking the $5.8 million from future Medicaid payments, according to the report.

The $2.65 million will go to a local charitable foundation that provides funding for nonprofit organizations that offer healthcare services.

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