UNM Hospital is feeling the squeeze because of new health insurance policies.
The hospital has reserved 22 percent of its annual revenue for the upcoming year to fund unpaid hospital bills caused by a variety of issues, including unreimbursed Medicaid treatments, said Ava Lovell, senior executive officer for finance and administration at the Health Sciences Center.
New Mexico used to run a Medicaid program called Salud, but since Jan. 1 the state, in following the national health care reforms, changed that program entirely, now calling it Centennial Care, according to the New Mexico Department of Health website.
“The change from old Medicaid to this new Centennial Care has been difficult. Human Services, Department of Health rolled out a new system including a computer system,” Lovell said.
Because of the new system, all Medicaid enrollees had to re-enroll under the Affordable Care Act, switching from the old Medicaid to Centennial Care and enrollments of many new patients have caused issues, Lovell said.
With the new computer system, UNMH is having problems getting reimbursed from Centennial Care because there are four companies in New Mexico handling Centennial Care billing for the state, she said.
Many patients end up getting lost in the shuffle, and the bills never get paid, she said.
“It is hard for people at a hospital like ours to know who to bill for that patient and so it is just kind of difficult right now,” Lovell said. “I know the state is working really hard to get that cleaned up but this is not only our hospital and doctors but across the state.”
The New Mexico Hospitals Association had earlier claimed that some hospitals were on brink of closure due to the reduction in the financial capabilities, according to an Albuquerque Journal report.
According to the latest figures issued by the Health Services Department, 709,322 New Mexicans were re-enrolled in the Medicaid program.
In addition to losing funds because of the new insurance guidelines, many bills go unpaid when homeless patients or uninsured patients leave the hospital after receiving care, without paying their bill.
However, Lovell said that is very typical for UNM.
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“We are the state’s safety net hospital, so it wouldn’t be surprising that we would do a lot of charity care, and included in that would be the working poor who cannot afford insurance but make too much for Medicaid,” she said. “So now you’ve got a lot of people who cannot afford health insurance and if they a have a big medical event we end up writing that off.”
The UNMHSC overall budget for fiscal year 2014-15 is about $1.7 billion, Lovell said.
UNMHSC has a separate budget from the main campus, which is approved by the Board of Regents, she said.
Sayyed Shah is the assistant news editor at the Daily Lobo. He can be reached at assistant-news@dailylobo.com or on Twitter @mianfawadshah.