Albemarle Regional Health Services has won back Medicaid payments it said a state agency wrongly withheld – though it’s not clear if it will get back the $1 million-plus ARHS Director Jerry Parks has said it’s entitled to.

Last fall, Parks reported to ARHS counties’ commissioners that the N.C. Division of Medicaid Assistance had changed how it pays out cost settlements under Medicaid, a major funding source for the seven-county health department. Medicaid is a federal program that pays the healthcare costs of the poor. The program is administered by the states.

The cost settlements mean ARHS is paid closer to actual cost of certain services it provides. Going back several fiscal years, Parks estimated then that the state’s new restrictions on reimbursements cost ARHS around $1 million. Health departments across North Carolina similarly faced similar losses from DMA withholding federal funds, and they’ve been lobbying regulators and lawmakers on the issue.

In a report to ARHS board members Tuesday, Parks reported those efforts had paid off, to an extent. The state budget – which has now been passed by the General Assembly – adds $14.8 million for cost settlements.

As of Friday it remained unclear how far that money would go. ARHS spokeswoman Jill Jordan wrote in an email that “it is too soon to know how these funds will be distributed to the local level.”

She continued that ARHS cost settlements dating back to 2011 are under review, and the agency couldn’t project what it would receive.

“It would be premature to speculate on what those final amounts will be at this time because each year was settled at a different rate and a different percentage of payment,” she wrote.

However, she noted that ARHS expects to receive about $775,000 in cost settlement funds for 2015-2016 and has budgeted a “very conservative” amount, $450,000, for the 2016-2017 budget.

Parks argued last year that DMA’s changes to Medicaid cost settlements were unjustified – but Jordan indicated Friday that Medicaid and its payments remain in flux.

“The N.C. Medicaid system is currently undergoing a great deal of change in an effort to contain costs and assure benefits to those in need,” she wrote. The DMA is leading the process and continuing to “dialogue” with the N.C. Association of Local Health Directors and the N.C. Association of County Commissioners, she said, while also seeking guidance from the Centers for Medicare and Medicaid Services.

ARHS wins back Medicaid payments
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