U.S. Senators Charles E. Schumer and Kirsten Gillibrand today secured a reimbursement payment from Medicare via the fiscal intermediary the National Government Services (NGS) for $2,930,287 owed to the Carthage Area Hospital in Jefferson County. The hospital had an outstanding Sole Community Hospital Low Volume Adjustment repayment request initially submitted on September 3rd, 2014. The reimbursement covers operational costs for medical services rendered to patients.
Last July, Carthage Area Hospital made the transition from a Sole Community Hospital to a Critical Access Hospital, giving the hospital improved “cost-based facility services” for reimbursement rates. During the changeover, Carthage Area was still required to bill Medicaid and Medicare plans as a Sole Community Hospital. The hospital then had to repay insurance companies through recoupments all of the funds already paid to them and then rebill for the services under the new rate.
“For years, I have long fought to make sure our New York hospitals, like Carthage Area Hospital in Jefferson County, receive the Medicare reimbursement funding to which they are entitled,” said Senator Schumer. “Now, Carthage will finally receive the payments it needs and deserves, which will provide a huge boost to its hospital funding and greatly improving its financial status. This is a victory for Carthage and will go a long way towards supporting the high-quality care it provides to Fort Drum families and North Country residents.”
“Carthage Area Hospital is a lifeline for patients and families in the community,” said Senator Gillibrand. “The hospital’s emergency, therapy and social centers have treated, cared for, and saved countless lives. We must do everything we can to help the hospital and its workers continue to provide first-rate care and remain open to the public. This reimbursement will help keep the hospital doors open.”
“As we continue to make the necessary improvements at Carthage Area Hospital, the assistance provided by Senators Schumer and Gillibrand to obtain the Low Volume Adjustment was vital,” said Rich Duvall, CEO of Carthage Area Hospital. “The monies will help with our continued financial sustainability and ensure Carthage Area Hospital remains a vital provider of healthcare services to our communities.”
“Carthage Area Hospital is very appreciative of the effort that Senator Gillibrand, Senator Schumer, and their staff put forth in working to get the Low Volume Adjustment processed in a timely matter,” said Rob Bloom, CFO of Carthage Area Hospital. “This will provide much needed liquidity to the Hospital as we continue work through the Critical Access conversion process, which, will help to ensure the Hospital remains a provider of high quality healthcare.”
During that time, the hospital had to re-configure its finances as a Critical Access Hospital, receiving new cost based rates, renegotiate contracts, and go through the recoupment and re-adjudication process which added to the financial strain. Receiving the reimbursement from NGS will assist Carthage Area Hospital in remaining financially solvent through the upcoming months.
After the inquiry was made by the Offices of Senators Schumer and Gillibrand, NGS responded to Carthage Area Hospital with a notification of payment within 30 days.