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Agreement reached on Medicaid payments to John R. Marsh Cancer Center

February 22, 2012|By ANDREW SCHOTZ | andrews@herald-mail.com

A Medicaid reimbursement issue affecting the John R. Marsh Cancer Center in Washington County apparently has been resolved.

This was the second straight year Del. John P. Donoghue, D-Washington, presented a bill trying to fix what was seen as technical language that hurt the center.

Donoghue’s bill would make a “provider-based outpatient oncology center” eligible for reimbursement at a percentage of the applicable Medicare rate.

To qualify, a center has to be associated with a hospital, but off the site.

Last year, when the same bill was introduced, Raymond A. Grahe, Meritus Health’s vice president for financial services, said the cancer center had $2.6 million in charges in the previous six years that were considered “charity care” because the system wasn’t reimbursed.

The House Health and Government Operations Committee heard the bill last year, but Donoghue later withdrew it after hearing that the state Department of Health and Mental Hygiene had worked out a solution.

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However, the solution never went into effect, so Donoghue pursued the same bill this year.

Now, he has withdrawn the bill again. But this time, Donoghue said he has an agreement in writing.

A Feb. 13 letter from Charles Milligan, DHMH’s deputy secretary for health care financing, said the John R. Marsh Cancer Center is the only facility that meets the definition of “provider-based outpatient oncology center.”

Oncology services had been offered at what was then Washington County Hospital, but moved to its own site in 2004, the letter said.

The department is drafting a State Plan Amendment that would authorize Medicaid reimbursement for the center, probably effective July 1.

Money has been included in the state’s fiscal 2013 budget.

Milligan said during a telephone interview that there was an agreement last year, but additional money for what was considered to be a Medicaid expansion wasn’t approved in the budget.

He said the Marsh center was eligible for Medicaid reimbursement before, but not at the facility level, which the new agreement accomplishes.

A Department of Legislative Services chart shows that the change would increase Medicaid expenditures by about $376,000 in fiscal 2013, with half coming from the state.

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