$27M Medicare, Medicaid funds projected for CHCC

The Commonwealth Healthcare Corp. projects nearly $27 million in reimbursements from both Medicare and Medicaid programs this fiscal year and the next, based on budget documents the corporation turned in to the Office of Management and Budget.

The corporation specifically identified $15.906 million and $10.688 million in projected revenue from Medicare and Medicaid reimbursements in fiscal years 2014 and 2015, respectively.

Compared to the actual reimbursements realized in previous fiscal years, current projections for fiscal years 2014 and 2015 for both programs reflect a huge jump.

Records show that the corporation got a total of $2.953 million from Medicare in fiscal year 2012, and $9.067 million from Medicaid during the same period.

In fiscal year 2013, Medicare reimbursements amounted to $$8.391 million, while Medicaid funds totaled $10.116 million.

Medicare is a federal program that provides health coverage if you are 65 or older or have a severe disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income.

CHCC receives reimbursement from these two programs for providing treatment and healthcare services for both programs’ clients in the CNMI.

CHCC is asking for a $41.5 million operational budget for fiscal year 2015, which starts on Oct. 1 this year. This submission is based on collections and revenue it expects to raise in the next 12 months.

OMB documents show that CHCC expects to earn a total of $36.803 million for the hospital side: Medicare ($15.906 million); Medicaid ($10.688 million); private insurance ($6.356 million); Guam Marianas Collection Agency ($309,331); rental lease ($79,500); grantor’s upfront payment ($2.356 million); indirect cost ($756,470); cafeteria lease ($60,000); and health electronic record incentive ($280,610).

In the Public Health Division, the projected revenue for fiscal year 2015 is at $403,833. It also expects the Rota and Tinian health centers to generate $367,680 and $516,674 respectively.

Next fiscal year’s proposed seed money of $3.469 million was also factored in the overall budget submission of $41.5 million.

CHCC’s revenue projection in fiscal year 2015 ($41.5 million) is slightly higher than what it projected for fiscal year 2014 ($40.933 million). The difference is due to an anticipated lower incentive for the hospital’s electronic health record system, which received $1.12 million in fiscal year 2014 and only $280,610 expected in fiscal year 2015.

CHCC has indicated it will continue to incur unforeseen expenditures as it continues to address Medicare compliance.

The U.S. Centers for Medicare and Medicaid Services is expected to decide on CHC’s Condition of Participation in June this year.