West Virginia Medicaid Facing Two Lawsuits, Withdrawal by Health System Due to Underpayment

Citing underpayment, a hospital has filed a lawsuit against the West Virginia Medicaid program, a network of community health centers is planning another lawsuit and a health system has stopped treating patients in the program, according to a report by the Charleston Daily Mail.

Appalachian Regional Healthcare, parent company of the Beckley ARH Hospital, filed a lawsuit alleging the state program that reimburses 67 percent of costs with increases that lag behind inflation. With one-third of its patients in Medicaid, the hospital said if payments don’t improve, it may have trouble buying new equipment, keeping pay competitive and it may even have to close its doors.

In addition, the West Virginia Primary Care Association, which represents community health centers, said it would sue the state because its network of centers and clinics are "grossly underpaid" by Medicaid. And in October, the University of Virginia Health System announced it would stop taking Medicaid patients from West Virginia because this state's payment rates are "substantially below cost."

The chair of the Health and Human Resources Committee in the West Virginia House indicated support for raising Medicaid reimbursements by a "fair amount." Democrat Don Perdue said such action would attract more physicians, who have also been fleeing the program because of low reimbursements.

Read the Charleston Daily Mail report on Medicaid.

Read more coverage of Medicaid payments:

- Declining Payor Mix Involved in Indiana Hospital Merger


- Delayed Congressional Action on Medicaid Funding Helps 16 States, Hurts 24 Others

- Texas State Lawmaker, Governor Propose Withdrawing From Medicaid



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