Medicaid cut-off fought

LINCOLN — A top Nebraska Medicaid official hopes to persuade the Mayo Clinic to keep treating Nebraska Medicaid patients beyond year's end.

Vivianne Chaumont, the state Medicaid director, said Tuesday that the state is talking with clinic representatives about reversing a decision announced early this month.

“They are a good choice to have available,” she said.

The renowned clinic in Rochester, Minn., notified the state that it plans to stop taking Nebraska Medicaid patients as of Jan. 1.

Letters also are being sent to about 30 Nebraska Medicaid patients who visited the clinic more than once in the past two years.

Clinic spokeswoman Shelly Plutowski cited business reasons for the decision.

Mayo's three clinics — in Rochester, Florida and Arizona — provided more than $500 million worth of services to Medicaid patients last year and lost more than $100 million on those services.

“There are difficult decisions for us to make,” Plutowski said. “This isn't something we would prefer to do.”

She said officials with the Rochester clinic have decided to serve Medicaid patients only from their core area — Minnesota and the surrounding states of Iowa, Wisconsin and North and South Dakota.

The decision affects patients from Montana as well as Nebraska.

Plutowski said the decision was not made because of problems specific to either state's Medicaid program.

Rather, Medicaid programs generally have low reimbursement rates and large amounts of paperwork. She said the amount of paperwork was “significant” for the small number of patients from those two states.

Chaumont said the notification letter was her first indication of any problems.

“I don't really think this is a Nebraska issue, I think this is a Mayo Clinic issue,” she said.

Nebraska's reimbursement rates are better than those of many other states, according to the Henry J. Kaiser Family Foundation, and the state is willing to negotiate payment rates.

Chaumont said Medicaid paid claims for about 100 Nebraska patients at the Mayo Clinic last year. The program pays for out-of-state services when similar care is not available in Nebraska.

She said the Medicaid program will work with providers and patients to find alternatives to the Mayo Clinic.

The Mayo Clinic will consider keeping Nebraska Medicaid patients as charity cases if they cannot find the care they need elsewhere, Plutowski said.

About 6 percent of patients at the three Mayo clinics are on Medicaid or are considered charity care, she said.

That's well below the average for other large teaching hospitals and below the 29 percent rate for Medicaid patients at the other hospital in Rochester.

Medicaid patients account for 13 percent of Nebraska hospital patients, according to the Nebraska Hospital Association.

In a separate announcement, Mayo said it will no longer accept Medicare payment for primary care patients at its Glendale, Ariz., facility.

Medicaid is a state-federal partnership that pays for health care for low-income children, families, the elderly and the disabled. Medicare is a federal program that pays for health care for the elderly and some people with disabilities.

Skeptics question Mayo's argument that it needs to cut back on Medicare and Medicaid patients because those payments are so far below its costs. While Mayo is adept at limiting unnecessary procedures, they note, the costs of the procedures it does provide are high.

This report includes material from the Washington Post.

Contact the writer:

402-473-9583, martha.stoddard@owh.com

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