GMH receives $6 million from CMS

February 7, 2019

 

 

The Centers for Medicare & Medicaid Services (CMS) has approved the Guam Memorial Hospital’s request for a rebase adjustment, subsequently increasing the Medicare reimbursements for inpatient services and infusing much needed resources to the island’s only public hospital.

 

On Jan. 12, GMH received notice from Noridian, the contractor for CMS that CMS has approved GMHA’s request to rebase its rate for services to patients under Medicare admitted at the Guam Memorial Hospital. The rebase is effective Oct. 1, 2013.

 

“It has been over 20 years since the last rebase was approved. GMH has been seeking a more recent rebase for many years. And with the new 2013 rebase, GMH’s Medicare reimbursements will now be comparable to that of other similarly-sized U.S. hospitals,” said Lillian Posadas, GMH administrator.

 

The original rebase amount of $5,154 per hospital discharge was set in 1998, and was based on data collected between 1992-1994. GMH’s new rebase amount is $9,511 per discharge, and will increase annually based on a market basket index. With the new base rate, CMS will determine a new per diem payment for inpatient services which will trigger the change in per diem rate for Medicaid and MIP patients. In the coming years, GMH estimates that it will receive additional payments of over $6 million annually.

 

Moreover, due to the rebase, GMH has received, retroactively, additional Medicare payments of $6.3 million for services provided in FY2014 through FY2016.

 

GMH also expects to receive an additional reimbursement of over $4 million for FY2017 and FY2018. “This is historic for our island. GMHA has been working for decades to get its CMS base rates adjusted and we have finally been approved. I want to thank the great work that was done by past administrators and management at GMHA. Without them, this would not have been possible,” said Gov. Lou Leon Guerrero.

 

Sen. Therese Terlaje welcomed the good news. “The rebasing of CMS rates was worked on by many for so long that it is truly a testament to what we can achieve working together,” she said. ‘This is a great start toward improvements in healthcare and more good things to come for our families who suffer illness or accident, and for our entire Community.”

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