Gleason: Insurance bill would break the hospitals

The administrator of Havre's long-term care center asked local legislators Tuesday what their stance was on two issues: raising the payment rates for long-term care in Montana and proposals to set new rules in insurance paying medical bills.

Ron Gleason, administrator of Northern Montana Health Care's long-term care facility, said during a video conference in Havre with local legislators in Helena that the payment rates have been frozen to the 2009 levels, and now he is hearing some may want to reduce proposed increases.

The hospital has received information from the Montana Hospital Association that it would cost Northern $12.5 million in Medicare reimbursement over the next 10 years, Gleason said.

"If we don't see some changes in some of the other areas, it's going to cause some changes in programs, is what's going to happen," he said.

Rep. Wendy Warburton, R-Chinook, said she supported the increases that were passed by the 2011 Legislature and cut out of the budget by Gov. Brian Schweitzer, and continues to support them.

Rep. Kris Hansen, R-Havre, echoed that.

"Wendy and I both support the provider increases from last time, and that wouldn't change in my book," she said.

Sen. Greg Jergeson, D-Chinook, said the real question is what is put in the appropriations bill to pay the providers.

"That's where the rubber meets the road," he said.

Gleason also asked about House Bill 450, which sets health insurance companies as a "payer of last resort" in the case of an automobile crash where the injured parties have coverage from auto insurance.

The bill states that its underlying reason is lawsuits being filed in the state that slow down payment to the health care providers.

Gleason noted that during a meeting with legislators in Havre last Thursday that the bill was described as a battle between the trial lawyers and the health insurance companies.

"The only problem is, the people who are being sued are the hospitals, not the insurance companies … ," he said. "I think you need to take it with a grain of salt that it's a battle between the trial lawyers and the insurance companies, though, because the insurance company is not who is sued. It's the hospitals, and they're asking for millions of dollars to come out of the hospitals, and in the current atmosphere, the hospitals can't afford it. It's going to break us."

Hansen said the bill already has passed out of the House — she voted for it, Rep. Clarena Brockie, D-Harlem, voted against it and Warburton was excused — so it now is in the hands of Jergeson.

Jergeson said he will be watching very closely for the bill if it comes out of committee.

He said during the meeting with local legislators last week in Havre that he believes it is between the lawyers and the insurance companies, and that the hospitals are getting caught in the crossfire.

"It's the health insurance companies that want to transfer the risk of paying for injuries over to other lines of insurance," he said, adding that that would end up causing the rates for auto and home insurance to go up.

He said he voted against a bill, which still passed out of the Senate, that would do the same thing but include homeowner insurance.

Havre attorney Brian Lilletvedt raised the issue at the Havre meeting Thursday, saying it is an attempt from health insurance companies to get out of a contractual obligation — people are paying hundreds or thousands of dollars a month to get health insurance coverage that the companies then will not pay.

"I just don't see how that's a consumer-oriented bill," Lilletvetd said.

He noted that the bill lists as one of its reasons the requirement in Montana that Medicaid is a payor of last resort, that any third-party insurance is exhausted before Medicaid pays.

But Medicaid is a non-profit government program, Lilletvetd said.

"The health insurance industry is for profit, and this bill simply gives them more profit," he said. "It makes them a third or fourth payor, so you get no bang for your buck."