GRANTS – The Cibola General Hospital changed its Miners’ Testing Stage II policy on Jan. 28.
“It was open to just county residents,” explained CEO Mike Makosky.
“The board approved moving forward with testing only New Mexico residents in order to minimize [financial] losses,” reported Executive Assistant Jenny Jensen after the January board meeting.
The U.S. Department of Labor decides applicants’ eligibility for this type of testing, noted Makosky.
He updated the board about changes in DOL reimbursement procedures.
“Every hospital in the country will bill and be paid in same fashion, which will make a level playing field for reimbursement,” explained Chief Financial Officer Jeff Rimel.
Chief Clinical Officer Pam Akin stated, “If they can go to any hospital for this test, then they should go to the one in the county where they live since all hospitals are being reimbursed the same.”
Rimel responded, “A lot of hospitals won’t do the test and that’s one reason they are coming to us for the Stage II. We are recognized and now we are known for doing this procedure. We seem to get more than our share asking for the test. ”
He suggested only providing the service for state residents and several board members agreed that it would be easy to verify residency.
Makosky responded, “We should encourage out-of-state residents to go to their own hospital. We did 69 tests for out-of-county patients and 46 were from New Mexico, which was not quite as many as we had originally thought.”
Some of the out-of-state patients had worked in New Mexico uranium mines and the hospital has tested patients who now live Washington, Wyoming, Colorado, Florida, according to CGH officials.
The higher altitude here means that applicants get better test results for their pulmonary dysfunctional condition(s) noted several board members.
“We can’t turn them away,” said Dr. Janice Shipley, chief medical officer, “if they have spent money getting here.”
“We will continue to encourage them to seek the testing services at their local hospital,” responded Makosky.
He emphasized that the hospital never wants to take a loss on anything including providing services.
“There have been people who were not honest about their residency,” noted Rimel.
Makosky and Rimel agreed that until last year CGH had received full reimbursement for the Stage II testing.
“We are looking at a number of variables in the projections,” said Rimel, “but compared to the old reimbursement method the hospital will receive 60-70 percent less from DOL for doing the same procedures.”
“We’ve talked with Senator Tom Udall’s Washington, D.C. office staff and with the DOL employees in D.C.,” recalled Makosky. “They [DOL] have pretty much dug their heels in – so it is what it is.”