Dispute Over Stephens Co. Hospital Medicare Funds Continues

February 18, 2014

Stephens County Hospital continues trying to resolve a dispute over hundreds of thousands of dollars in Medicare funds.

Last Fall, the hospital reported that it had around $800,000 in Medicare funds withheld by Medicare over a dispute that stems from Medicare paperwork filed by the hospital back in Fiscal Year 2009.

Hospital Administrator Ed Gambrell said the hospital claims Medicare owes it money, while Medicare made the claim that the hospital in fact owed money back to Medicare.

Gambrell said the hospital and its auditors remain confident that the hospital will receive all of the funds withheld over the dispute.

He added that an official with the company that administers Medicare in Georgia has also looked at the issue.

“We have gotten a higher-up to look at the cost report and he agrees with us,” said Gambrell.  “We think it is just a matter now of going through their system.”

Gambrell said he hopes the matter finally gets resolved in the coming weeks.

He said the hospital, if it goes as he expects, will receive a significant amount of money.

“Between what they took from us and what we owe them, plus they are going to have to pay us a penalty and interest for withholding our money, they are going to have to pay us about a million dollars,” said Gambrell.

Gambrell said receiving that money will continue to help the hospital’s cash flow situation, which was tight at the time Medicare withheld the funds last year, but has improved since then.

Speaking of the hospital’s bottom line, the Hospital reported at Monday’s Hospital Authority meeting that it suffered a slight financial loss in January.

Gambrell said he remains comfortable with where the hospital stands for this fiscal year.

“We have stabilized more than last fiscal year in terms of losing dollars,” said Gambrell.  “I continue to feel confident that we are going to be operating around the break-even mark this year.”

In other news from Monday’s Hospital Authority meeting, Gambrell reported that the hospital did not have any major problems during last week’s winter storm.

Gambrell said that everything ran well.

He said many staff stayed at the hospital to ensure they were at work during the storm.

“We had zero staffing issues because of the snow,” said Gambrell.  “We briefly lost power in parts of our personal care homes and the hospital Wednesday night.”

Gambrell said that power outage lasted less than an hour.

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