Lowndes County is partnering with a Jackson company to lower jail inmate medical costs.
At Monday’s meeting, the board of supervisors granted County Administrator Ralph Billingsley permission to work with Gulf Guaranty Employ Benefits Service to review the county’s medical bills for inmates in the Lowndes County Adult Detention Center.
Billingsley said the Mississippi Association of Supervisors has contracted with Gulf Guaranty to essentially audit charges to ensure that providers only charge counties what’s required by state law.
“State laws say the county isn’t responsible above whatever the Medicaid reimbursement rate is,” Billingsley said. “For example, if a procedure is $200 on a Medicaid reimbursement rate, we can’t pay more than that. They audit to make sure it’s within what the law says.”
Gulf Guaranty President Richard Cothern said the company will get the county’s inmate medical bills from providers and review them before sending them on to the county.
If a bill isn’t overcharged, it’s sent directly to the county. For those that do contain overcharges and are adjusted, the county keeps 95 percent of the savings, while Gulf Guaranty takes 4 percent and the Mississippi Association of Supervisors gets 1 percent.
For example, if a bill is charged at $250 when the reimbursement rate is $200, Gulf Guaranty would contact the provider and have the bill adjusted. From there, the county would pay the company a $2 fee and the supervisors association 50 cents.
Cothern said the law dictating what counties can pay for inmate medical costs took effect in 2011. However, he said there’s been some delay between the law taking effect and health care providers becoming more familiar with it.
“Even though the legislature put a burden of compliance on the counties, it did not put a burden of billing procedures on the providers,” Cothern said. “You have providers who have no obligation to be compliant, but you also have counties who have to find a way to be compliant with a fee schedule.”
Still, he said it has become less of an issue as providers have become more familiar with the law.
“We’re running into that less and less,” he said. “Most providers now understand that it’s in place. We’re having the conversation to explain it less and less.”
Gulf Guaranty works with 42 of Mississippi’s 82 counties, Cothern said, adding the program has saved taxpayers about $4.2 million in the year it has been available.
Jail procedures
Capt. Richard Jones, administrator of the Lowndes County Adult Detention Center, said medical costs can be a significant portion of the facility’s budget.
The jail has a $3.3 million budget, and Jones said about $300,000 of that is devoted to inmate medical care.
Still, expenses can swing broadly from year to year based on how many inmates get sick and what sort of care they need. Billingsley said the county spent $176,000 on inmate medical care for the 2015-16 fiscal year.
The jail has a nurse and a paramedic on staff. Jones said it also has a doctor on call who visits once per week. Mississippi University for Women nursing students also shadow on-staff medical personnel at the jail.
Inmates report medical issues, see the in-house medical staff for diagnosis and receive treatment at the jail, if possible. Jones said the jail sends inmates with more serious needs to outside clinics or hospitals for treatment.
He said about 60 inmates visit the emergency room per year. The jail has a 288-inmate capacity, and Jones said it averages about 240 to 250 inmates.
“We try to provide the best care that we can,” Jones said. “As long as they’re in our custody, we’re going to provide care.”
However, Jones pointed out that the costs for caring for inmates can extend beyond medical bills.
As an example, he said one inmate who suffered from cancer had to receive radiation treatment, and additional measures to care for her proved expensive.
“The jail is not set up to be a medical facility or mental health facility, so we had to make special arrangements to put her in a special place where we could observe her,” he said. “Being that she was taken to radiation, we had to have a change of clothing and provide all her care for that.
“One week of doing all of that cost us $696 just for the clothing and the mats, because we couldn’t reuse anything,” he added. “Anything she touched, we had to throw away.”
Jones said the jail’s nurse normally reviews the facility’s medical bills to make sure providers aren’t overcharging. The county working with Gulf Guaranty should leave more time for the nurse to tend to inmates.
It’s unclear how much working with Gulf Guaranty will ultimately save for the county. Cothern noted that Lowndes County already does a good job of managing costs, which limits the potential for savings.
“When I go into a county that’s already doing a good job, obviously the impact is not as great,” he said. “I expect to add to their compliance (and) peace of mind and be able to help with better reporting procedures.”
Alex Holloway was formerly a reporter with The Dispatch.
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