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Medicare, Medicaid, and Molina Health Care Swing Bed


October 31, 2019

DAYTON–During the recent Columbia County Health System (CCHS) meeting, they discussed the continuing process to build funds in anticipation of a $1.15 million payback to Medicare. The $1.15 million is an estimate at this time. The final number should be known after the Cost Report for 2019 is finalized around March or April of 2020.

The CCHS previously reported that Medicaid owed the district over $1 million due to inappropriate write-offs by contract billing processors. The Hospital now has three active claims with the three Medicaid Managed Care programs: Molina, Amerigroup, and Coordinated Care. At this time no settlement has been made although there has been movement in each program’s position.

The CCHS had previously closed “swing bed” services for several months to patients of Molina Healthcare (one of the Medicaid Managed Care programs) due to billing issues. Swing bed is defined by regulations from the Centers for Medicare and Medicaid Services (within the Department of Health and Human Services of the federal government) and permits certain small, rural hospitals to use their beds, as needed, to provide either acute or skilled nursing facility care. Hospitals using swing bed services must have approval from Centers for Medicare and Medicaid Services. The Hospital has implemented new billing protocols and are hoping to add the swing bed service back for Molina Healthcare patients.

In other business, CCHS discussed some of their outreach accomplishments which include:

-Receiving blueprint and design for the Dental expansion, looking for design and equipment pricing. It is hoped to reach a decision before year end to either move forward with a Dental expansion in 2020, or decide not to expand at this time.

-Participated as speaker at Greater Columbia Accountable Communities of Health to support Blue Mountain Foundations efforts in directing community funds. Blue Mountain Foundation was instrumental in helping the hospital fund their new van.

-Columbia County Health System is sponsoring the Chamber Annual Awards banquet

-A marketing team will create a design for the new van to promote health services. Columbia County Health System is appreciative for the sponsoring agencies that helped purchase the van.


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