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Some N.M. Medicaid Payments on Hold

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SANTA FE — The state last month suspended certain supplemental Medicaid payments to hospitals as it negotiates a dispute with the federal government over the amount New Mexico should receive.

In the past, that affected funding amounting to about $250 million annually, according to Matt Kennicott, spokesman for the state Human Services Department.

“We suspended the payments to make sure we’re doing it right” under the rules of the Centers for Medicare and Medicaid Services, the federal agency that oversees the funding, he said Tuesday.

Alex Valdez, chief executive officer of Christus St. Vincent Regional Medical Center in Santa Fe, said he is “very concerned” about the matter, which could affect the $6 million the hospital gets annually for being a “sole community provider.”

The federal dollars under that program are matched with a contribution from the county indigent fund, whose dollars are allocated by the Santa Fe County Commission.

The federal supplemental funding under question, which goes to hospitals across the state, is made up primarily of the sole community provider, “disproportionate share” (for hospitals that see more uninsured patients than others in its community), and county indigent programs, according to Kennicott.

Sole community provider funding affects mainly hospitals that are alone in providing acute and high-level medical care in their region, so it affects smaller cities and towns more than Albuquerque.

But hospitals such as the University of New Mexico Hospital get other supplemental funding, such as the disproportionate share program. Steve McKernan, chief executive officer for UNMH, said that hospital gets $32 million annually through the supplemental funding that has been impacted by the payment suspension.

“Normally, the payment we would get has not been made yet,” he said. Such payments to hospitals are made on a quarterly basis, Kennicott said, and the December payment was not sent out.

Kennicott declined to elaborate on the specific elements in New Mexico’s supplemental funding that are under federal scrutiny, noting that talks are in a sensitive stage. “It’s about the methodology used to determine the amount of supplemental payments to hospitals,” he said.

Asked if New Mexico might be required to repay any federal money it already has received, Kennicott said, “I don’t think that’s likely … We really want to keep this looking forward.”

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