Supreme Court orders Medicaid to pay hospitals back $2M

April 13, 2018, The Clarion-Ledger, Anna Wolfe- The Mississippi Supreme Court has ordered the state Division of Medicaid to pay back $2 million to 12 hospitals, saying the agency improperly skimped on reimbursement for services. The hospitals, including River Oaks Hospital in Flowood, St. Dominic in Jackson, Northwest Mississippi Regional Medical Center in Clarksdale and Biloxi Regional Medical Center, had sued over Medicaid’s recalculation of outpatient rates for 2001. After every year, Medicaid looks at the charges and reimbursement rates to see if hospitals were overpaid or underpaid for the services they delivered. This usually takes a few years, but Medicaid had trouble adjusting the rates for 2001 and didn’t do so until 2010. The division has a formula - costs divided by charges - to determine how to reimburse hospitals for outpatient services. This excludes laboratory and radiology services, which should be reimbursed on a fee-for-services basis according to the State Medical Plan

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