St. Luke’s hospital unable to take Medicare, Medicaid patients after accreditation error

St. Luke’s Nampa (Idaho) Medical Center, a new hospital under Boise, Idaho-based St. Luke’s Health System, cannot take nonemergent Medicare and Medicaid patients unless they pay out-of-pocket for services, the Idaho Statesman reports.

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The holdup concerns an accreditation error. St. Luke’s officials thought after the Nampa hospital prepared for and passed an accreditation survey, the government would allow it to bill back for patient services administered since its Oct. 30 opening. However, Medicare does not allow hospitals to bill back to the date of opening, but rather to the date of the accreditation survey. As a result, St. Luke’s Nampa Medical Center may not be approved to bill federal health insurance plans until the beginning of December.

“We were operating under information that was not accurate,” Kathy Moore, CEO of St. Luke’s western region, told the Idaho Statesman. “We thought that we could, once we had our survey, that Medicare allowed us to back-bill our patients … back to the date of opening.”

St. Luke’s Nampa requested an expedited survey after its billing office discovered the mistake. It hopes the survey, which is unscheduled, will take place early next month.

St. Luke’s Health System’s recent experience with accreditation surveys is minimal, according to the report. Most of its new hospitals were acquired and not brand-new facilities. 

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