In my rural county, a hospital from a nearby larger town has contracted with our county to provide us with a clinic, doctor, staff, equipment, etc. in exchange for the county to pay $x per year. Now, the hospital wants the county to contract with the hospital whereby the county sends the payment for the hospital to Austin as part of the Upper Payment Limit of the Texas State Medicaid Plan. Austin would then send up to 2.5 times the money back to the hospital to be used for indigent care (presumably in our county, but could be used anywhere, I suppose).

Anybody know anything about these types of contracts or have any suggestions on how to advise my commissioners on this issue? We have a hospital board negotiating with the hospital, but final contract has to be approved by the commissioners (of course).

Concerns include (1) county not getting level of service previously provided, and (2) Medicaid fraud by hospital and liability of county for that fraud, and numerous other issues, I'm sure.

Any help or reference to help on this matter is appreciated!

Jody

[This message was edited by Jody Upham on 06-07-07 at .]

Good luck with that one.....
I am struggling with the same issue!
My understanding is a private hospital is unable to receive these funds without cooperation from a governmental entity. So, our county owned hospital sends funds to a larger, privately owned hospital in Lubbock. Still not sure what we get in return, but my hospital administrator assures me it is a benefit to the county. Allows the larger hospital to asssist us with more indigent care that we can't provide locally and we get a larger return on our investment....or some such convoluted nonsense. i know our first payment was a million bucks with some sort of payment due each quarter. Auditors are trying to figure it out as we speak. Sorry that wasn't much help other than to say I feel your pain!