State Stuck With Big, Late Medical Bills For Inmates
NASHVILLE, Tenn. -- A prominent state senator says taxpayers should not have to pay late medical bills submitted by a Tennessee hospital involving the care of state inmates.
The Regional Medical Center in Memphis, a county-owned hospital, has submitted bills up to six years late, for as much as a million dollars, to the Tennessee Department of Correction.
The chair of the Senate Finance Committee, Sen. Randy McNally, R-Oak Ridge, said the bills are outrageous.
"Six years old and they can't explain why they're that old. I don't think we should pay them," McNally said.
He questioned why the hospital is consistently submitting late bills for emergency inmate care that are higher than any other county.
"It's either incompetence or fraud -- and there's no way for us to determine, at least right now, what is behind it," McNally said.
The Med, as it's commonly called, claimed that it keeps finding records of inmates it treated years earlier but never submitted a bill.
For the past three years, the hospital has sent dozens of bills to a collections attorney who then sues the state.
This year, the state received a $1.4 million tab for treating 18 inmates from as far back as 2009.
The chief financial officer for the Department of Correction, Wes Landers, said those large bills are damaging the department's budget.
"What I can't plan for is when the service is provided in 2009, and I don't get a bill until 2013," Landers said.
He said there is no state law about how quickly bills must be submitted.
NewsChannel 5 Investigates asked, "You are still in a situation where you could a get a bill from six years ago?"
Landers responded, "Yes."
But the department is most concerned that the hospital routinely charges the state much more than TennCare or Medicare would pay.
"What's a fair amount?" Landers asked. "Don't bill us 100 percent or 103 percent of the cost just because it's the state of Tennessee paying for it."
The largest single bill the state received this year was for over $1 million for one inmate treated in 2009.
Among the itemized charges, $3000 dollars for an anti-fungal drug.
The charge is at least five times higher than the Medicare payment limit for that same drug.
"I guarantee you if that were my medical bill, I would have called them and said, 'I'm not paying $3000 for that medication,'" Landers said.
On a separate inmate, the hospital charged at least four times more than the average amount TennCare currently pays for a C-Section.
Landers asked, "Could we have negotiated that down? Yes."
He said that when the state gets the bills so late and through the court system, it is not able to negotiate down the cost.
NewsChannel 5 Investigates asked, "Is there any other county that submits bills as late and as high as Shelby County?
Landers answered, "No, to my knowledge."
For example, the single largest medical bill for emergency inmate care that Davidson County has sent to the state in the last five years was for a little more than $151,000.
Davidson County and a private company that houses state inmates have negotiated large discounts for inmate care at local hospitals.
Senator McNally is concerned by the growing number of financial problems coming out of Memphis and Shelby County.
"It's important that we maintain the state's fiscal integrity," McNally said.
But six-year-old medical bills are something for which the senator has a quick solution.
"I think we ought to just trash it," McNally said.
The hospital said in a statement that it has an obligation to collect payment and that it discussed the collection process with the Department of Correction.
The financial officer has been on the job about a year and was not aware of that conversation.
Here is the hospital's full statement:
"Regional Medical Center has an obligation to collect payment for care provided. In 2009 we discovered a backlog of claims for state inmate care that had not been reimbursed as allowed. Upon discovering these unreimbursed claims, we established a process, per T.C.A. §41-4-115(b), for requesting and receiving reimbursement for care provided to state inmates who present to the emergency department and then are subsequently admitted to the hospital. Over the past few years, we have worked diligently to ensure that we are paid for the services delivered when there is a payment source.
"The collection process that we began for state inmate care was discussed with the State Department of Corrections and also with our local Sheriff's office to determine options for collecting payments for this care. It was deemed appropriate by all parties to move forward with the established process for collecting payments due to the hospital for services provided to state inmates.
"Regional Medical Center completes the process of pulling records to identify state inmate care annually. Because this is an annual activity, followed by a complex process of verifying services and charges to file the petition, it is not uncommon for petitions to be filed containing charges from previous years. Copies of the petitions for payment go to the Sheriff's office for verification and sign off and are then filed with the state."