Roosevelt General still wrestling with clinic certification

By Sarah Meyer, PNT Staff Writer

The Roosevelt General Hospital Board of Directors is continuing its effort to have its clinics federally approved as hospital-based rural health clinics.

The topic was discussed during Tuesday’s board meeting.

A letter of approval from the department of health, which has been received, is only one step. A state survey or inspection is required to determine the need for the clinics, but CMS — Centers for Medicare and Medicaid Services — did not fund the states for the survey, said James D’Agostino, CEO and administrator of RGH.

“We have to have hard, concrete numbers to prove that, without the clinics, patients will be going without care,” D’Agostino said.

“We’re gathering information to file with the feds,” he said. The data will be used to file an exception request with the goal of getting CMS to have the New Mexico Department of Health conduct the survey.

Board member Peggy Davis said she has received calls from people “concerned we’re not going to get approved and it’s the hospital’s fault.”
“We’re partly to blame; they’re (CMS) partly to blame,’ said D’Agostino. “I think there’s errors on both sides.”

Davis also wanted to know if the hospital would be able to bill Medicaid/Medicare retroactively.

D’Agostino said if the hospital has to start a new application, it would not be able to bill retroactively and would lose those payments.

He later explained that the retroactive payments would be the difference between the hospital’s cost to provide service and the amount paid by Medicare/Medicaid.

The difference would be determined by a cost report, and since the clinics are new, a cost basis has not yet been established, he said, so the amount of any such payment is unknown.

The clinics in question are the former Eastern Medical Associates at the hospital and another clinic in Clovis.

RGH, along with Nor-Lea General Hospital in Lovington have launched a recruiting effort to get more doctors to staff the clinics, D’Agostino said.