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NMMC One of 8 State Hospitals Suing DHHS Secretary

| August 14, 2013

Fort Kent’s Northern Maine Medical Center is one of eight hospitals in the state involved in a lawsuit against the secretary of the Department of Health and Human Services. It all has to do with a reimbursement dispute between the hospitals and the Centers for Medicare and Medicaid Services that’s been going on for years.

Peter Sirois, the Chief Executive Officer at NMMC, calls it “a little disheartening because this goes back to 1997 and so a lot of time and energy and money has been spent trying to defend our point”

Sirois says when hospitals accept medicare or medicaid – they have to accept patients regardless of their ability to pay. And when a hospital has a disproportionate share of low income patients, they are then reimbursed by the federal government through Medicare. For 7 years hospitals were consistently reimbursed – but in 2005 the program changed, and required hospitals to pay back the reimbursement. After paying back the millions of dollars, the 8 Maine hospitals appealed to an independent review board – who determined that they were entitled to the reimbursement. However DHHS Secretary Kathleen Sebelius reversed that decision – and so the 8 hospitals filed the lawsuit against her Friday in US district court in Portland.

Sirois says, “We find it very unfair to pay and everybody tries to play by the rules of getting reimbursed and having the services to treat our patients in a proper way and getting reimbursed accordingly.”

Sirois says whereas other hospitals had participated in the reimbursement program for several years, NMMC is only asking for reimbursement from 1997, the year they applied and were accepted. He says they’re asking for 300-thousand dollars back, which will make a difference.

He says “For a small rural hospital in Northern Maine 300 thousand dollars means a lot to us so this appeal and banding with 8 other hospitals allows us to kinda carry the cost of the attorney amongst all eight of us rather than one hospital.”

Sirois says he and the other seven hospitals just want the Center for Medicare and Medicaid Services to fulfill their promise. Other hospitals involved include Eastern Maine Medical Center in Bangor and Maine Medical Center in Portland.

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