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Reimbursement formula found for indigent care

STORY BY MEG LAUGHLIN (Week of March 5, 2015)

Indian River Medical Center and Hospital District negotiators shook hands last week, verbally agreeing on a reimbursement formula for how the Hospital District will use taxpayer dollars to fund indigent care at the hospital.

Both sides are putting the agreed-upon reimbursement formula in writing and presenting it to their boards for approval over the next week.

While none of the negotiators would discuss details of the financial agreement until it is approved, the reimbursement formula is believed based on rates recommended by District consultant Ken Conner, who researched hospital finances to arrive at a “nonfederal rate” less than the Medicare rate paid by the District for years.

The three-year agreement is believed to approximate what the District proposed to the hospital in October.

“After a long, long, long time of frustrating negotiations, we at last have something positive,” said District negotiator Gene Feinour.

The agreement over the financial part of the Indigent Care Agreement is a positive step in the ongoing negotiation of the entire ICA, an umbrella contract between the hospital and the District, which defines what rights each side has. 

“Somebody could be unhappy, but I don’t expect that because the taxpayers should be infinitely pleased and I think the hospital will be happy, too,” said Feinour.

But there may be a glitch putting the new financial formula into practice because both negotiating teams previously agreed that, while they would negotiate the reimbursement amount apart from other issues, no component of the Indigent Care Agreement could be enacted until all parts of the contract are agreed upon.

“The reimbursement formula will not be exercised until the entire Indigent Care Agreement is rewritten, and that could be difficult,” said District chairman Tom Spackman, who praised the compromise but cautioned that it was “not a home run.”

In negotiating the larger, more complicated Indigent Care Agreement, the hospital and the District can’t even agree on whether to start over with a new, simpler umbrella agreement or revamp the current ICA. Further, there is disagreement over large portions of the language and an ongoing back-and-forth from line to line.

But, despite those and other continuing differences between the two sides, Feinour clung to the small victory last Friday.

“We all left the meeting feeling cordial and upbeat for the first time in a long time, and that’s saying a lot,” he said.