Tuesday, June 29, 2010

Riverwood announces changes for GAMC patients

Effective June 1, the funding for Minnesota's General Assistance Medical Care (GAMC) program has changed following a Minnesota Legislature decision in mid-May.
Medically necessary services for GAMC patients are now being provided through newly designated Coordinated Care Delivery Systems (CCDS). Four hospitals in the Twin Cities have been designated as CCDS and are continuing to receive reimbursement for caring for GAMC patients under the reformed GAmC program. Those hospitals include Hennepin County Medical Center, North Memorial Medical Center, Regions Hospital and University of Minnesota Medical Center-Fairview. According to the Minnesota Hospital Association, additional hospitals may establish CCDS status beginning Sept. 1 and Dec. 1.
General Assistance Medical Care is a state-funded program for low-income adults, ages 21-64, who have no dependent children and who do not qualify for federally funded healthcare programs.
In response to these changes in reimbursement for caring for GAMC patients, Riverwood Healthcare Center has set some new guidelines. In order to receive non-emergency care, GAMC patients must meet the following criteria: 1) The patient must have been seen at a Riverwood clinic during the past 12 months, from June 2009 through May 2010; and 2) The patient must have an established Riverwood physician or nurse practitioner.
GAMC patients requiring emergency care or hospitalization will continue to receive care at Riverwood. However, those who come to the emergency room or urgent care clinic seeking non-emergency care will be referred to seek care at a designated CCDS unless they meet the new criteria Riverwood has set. The GAMC program will continue to cover the cost of prescription medication without any restrictions on pharmacy choice or healthcare facility.
“We don’t like being in the position of turning away patients seeking medical care,” says Mike Delfs, Riverwood Chief Operating Officer. “Unfortunately, the unallotment of funding for GAMC has put Riverwood, as well as other small rural health systems, in the position of having to direct many of these patients to their CCDS for routine care."
The state of Minnesota has established an uncompensated care pool to reimburse non-CCDS healthcare facilities, primarily for emergency care offered to GAMC patients, but because of the limited dollars allocated, reimbursement to hospitals will likely be only a small percentage of the total cost of care.
For those GAMC patients who are able to continue to receive medical care at Riverwood, they will be put on a sliding fee scale billing system according to their income. They will also get help applying for MinnesotaCare, a publicly subsidized program for Minnesota residents who do not have access to affordable healthcare coverage. For application information, call MinnesotaCare at (800) 657-3672.
For more information and questions, local GAMC patients may call the financial assistance staff at Aitkin County Health and Human Services at (218) 927-7200 or (800) 328-3744. The Minnesota Department of Human Services (DHS) has posted information, including frequently asked questions and other resources for patients and providers, at www.dhs.state.mn.us/gamc.

Media contact: Arlene Wheaton, Riverwood Healthcare, (218) 927-5589, awheaton@sisunet.org