Sooner24
6/21/2006, 10:55 PM
Parkland bills to know no borders
Dallas County: Nations whose citizens get care will be asked to pay up
10:00 PM CDT on Wednesday, June 21, 2006
By KEVIN KRAUSE and SHERRY JACOBSON / The Dallas Morning News
Dallas County is planning to bill Mexico and other foreign countries for treating their indigent citizens at Parkland Memorial Hospital, a practice that county leaders say is becoming a drain on their resources.
County Judge Margaret Keliher said she doesn't expect the foreign countries to pay up, just as she doesn't expect neighboring counties to pay for treating their indigent residents.
But that's not the point, she said.
"If you're not Dallas County residents, then we think that where you're from should pay for indigent health care," she said.
The county is already preparing to send bills to several counties for treating their residents. Last year, the county had $76.5 million in health care costs associated with treating noncounty residents, according to numbers prepared by county staff.
Of that, $26.8 million was not reimbursed. However, only about $300,000 of those unpaid bills was for patients who qualified as indigent in other counties.
Collin County owed the most, according to county numbers, with $7.6 million in unreimbursed costs, of which $66,017 was for indigent care.
There are no laws that require counties or foreign nations to reimburse Dallas County for treating their residents.
Dallas County tried unsuccessfully to change the law during the last legislative session to require counties to reimburse indigent-care costs at higher rates.
Commissioner Maurine Dickey said county leaders want to send a message beyond North Texas.
"What's wrong with sending them a bill?" she said, referring to foreign countries. "We have the hope that they would think about paying up."
Under a new federal law, Parkland has already been reimbursed by the federal government for a portion of the costs of treating illegal immigrants. The payments are only for the first 48 hours of emergency care, but those reimbursements fall short.
For example, of the $4 million Parkland requested from the government for two recent quarters, it received just short of $2 million in reimbursements. A bill to the government for $2.9 million more is still pending.
"It's inappropriate for the court to just sit on this and not send a bill," Ms. Dickey said. "We owe it to Dallas County taxpayers."
Most of the unpaid bills for Parkland's out-of-county patients, however, did not involve indigent care. A report to county commissioners, dated June 6, indicated that the Dallas County hospital was stuck paying $298,161 for unpaid out-of-county indigent care in 2005. The total cost for out-of-county indigent care that year was $672,649, according to figures provided by Parkland's financial staff.
Much of the uncompensated care for out-of-county residents stems from underpayment by Medicaid, the state-federal insurance program for low-income people. Medicaid payments for non-Dallas County residents fell $11.9 million short of reimbursing Parkland's costs in 2005.
The unpaid costs were for patients who were seen in Parkland's emergency room, burn unit and neonatal intensive care unit.
John Gates, Parkland's chief financial officer, said the hospital supports the commissioners' decision to bill foreign countries.
"County commissioners have the ultimate authority to decide what we do," he said.
As of Tuesday, the hospital began documenting the number of indigent foreign nationals treated at Parkland, Mr. Gates said.
Parkland does not ask patients about their citizenship, he said, but under some circumstances, they know what it is. For example, some patients may carry foreign ID cards. But those represent a fraction of the number of foreign patients treated, he said.
"The likelihood of them paying us is not high," Mr. Gates said. "But we would know that it is an appropriate claim to bill them for. We're not going to bill anybody if we do not know for sure." :texan:
Dallas County: Nations whose citizens get care will be asked to pay up
10:00 PM CDT on Wednesday, June 21, 2006
By KEVIN KRAUSE and SHERRY JACOBSON / The Dallas Morning News
Dallas County is planning to bill Mexico and other foreign countries for treating their indigent citizens at Parkland Memorial Hospital, a practice that county leaders say is becoming a drain on their resources.
County Judge Margaret Keliher said she doesn't expect the foreign countries to pay up, just as she doesn't expect neighboring counties to pay for treating their indigent residents.
But that's not the point, she said.
"If you're not Dallas County residents, then we think that where you're from should pay for indigent health care," she said.
The county is already preparing to send bills to several counties for treating their residents. Last year, the county had $76.5 million in health care costs associated with treating noncounty residents, according to numbers prepared by county staff.
Of that, $26.8 million was not reimbursed. However, only about $300,000 of those unpaid bills was for patients who qualified as indigent in other counties.
Collin County owed the most, according to county numbers, with $7.6 million in unreimbursed costs, of which $66,017 was for indigent care.
There are no laws that require counties or foreign nations to reimburse Dallas County for treating their residents.
Dallas County tried unsuccessfully to change the law during the last legislative session to require counties to reimburse indigent-care costs at higher rates.
Commissioner Maurine Dickey said county leaders want to send a message beyond North Texas.
"What's wrong with sending them a bill?" she said, referring to foreign countries. "We have the hope that they would think about paying up."
Under a new federal law, Parkland has already been reimbursed by the federal government for a portion of the costs of treating illegal immigrants. The payments are only for the first 48 hours of emergency care, but those reimbursements fall short.
For example, of the $4 million Parkland requested from the government for two recent quarters, it received just short of $2 million in reimbursements. A bill to the government for $2.9 million more is still pending.
"It's inappropriate for the court to just sit on this and not send a bill," Ms. Dickey said. "We owe it to Dallas County taxpayers."
Most of the unpaid bills for Parkland's out-of-county patients, however, did not involve indigent care. A report to county commissioners, dated June 6, indicated that the Dallas County hospital was stuck paying $298,161 for unpaid out-of-county indigent care in 2005. The total cost for out-of-county indigent care that year was $672,649, according to figures provided by Parkland's financial staff.
Much of the uncompensated care for out-of-county residents stems from underpayment by Medicaid, the state-federal insurance program for low-income people. Medicaid payments for non-Dallas County residents fell $11.9 million short of reimbursing Parkland's costs in 2005.
The unpaid costs were for patients who were seen in Parkland's emergency room, burn unit and neonatal intensive care unit.
John Gates, Parkland's chief financial officer, said the hospital supports the commissioners' decision to bill foreign countries.
"County commissioners have the ultimate authority to decide what we do," he said.
As of Tuesday, the hospital began documenting the number of indigent foreign nationals treated at Parkland, Mr. Gates said.
Parkland does not ask patients about their citizenship, he said, but under some circumstances, they know what it is. For example, some patients may carry foreign ID cards. But those represent a fraction of the number of foreign patients treated, he said.
"The likelihood of them paying us is not high," Mr. Gates said. "But we would know that it is an appropriate claim to bill them for. We're not going to bill anybody if we do not know for sure." :texan: