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Misclassification costs Samaritan $250,000 reimbursement

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A 2011 misclassification of Samaritan Medical Center’s medical residency program has resulted in the loss of $250,000 in Medicare reimbursement, according to hospital spokeswoman Krista A. Kittle.

U.S. Sen. Charles E. Schumer, D-N.Y., made it clear Tuesday during a Senate Finance Committee hearing on the nomination of Marilyn Tavenner to be administrator of the Centers for Medicare and Medicaid Services that resolution of the issue is a top priority.

“For him to bring it up in a nomination hearing is pretty significant,” said Meredith C. Kelly, Mr. Schumer’s press secretary. “Unfortunately, it’s not a standard issue. I’m sure there’s some procedural issues on CMS’s end. This is kind of an unusual situation.”

Ms. Kittle said the misclassification is based on the hospital’s bed count of 246.

“We were misclassified for falling into a different category than what we are,” she said. “Our classification should not have changed.”

According to a news release from Mr. Schumer’s office, Samaritan was misclassified as not rural, and therefore lost Medicare reimbursement for more than three residency slots. Ms. Kittle said Samaritan’s attempts since 2011 to change the ruling have been unsuccessful, so the hospital sought help from elected officials to intervene on its behalf.

Since the misclassification, a CMS error, Samaritan has had to cover the $250,000 reimbursement loss.

“A quarter of a million dollars is a lot to a hospital,” Ms. Kittle said. “Right now, we have 7 residents in the program which were funded for. We actually have 12 here. That’s 4 residents we have to fund ourselves. Before this misclassification, we were funded for 10. We funded the two extra residents because this program is so critical to this community.”

Ms. Kittle said the hospital has retained several physicians in the community based on the medical education program. Two of them are family practice physician Benjamin Rudd and general surgeon Deborah Norris. The residency program is for a variety of specialities, but primarily focuses on family practice and internal medicine because primary care physicians are a top recruitment priority.

According to the news release, in the nomination hearing for Ms. Tavenner, Mr. Schumer said: “Samaritan Medical Center in Jefferson County has the extraordinary responsibility of providing top-notch care for Fort Drum’s military community and civilians alike, and the federal government must give it all the resources possible to be successful. I am urging the federal government and CMS to work with Samaritan Medical Center to resolve this misclassification that could rob them of three life-saving residency slots, so that this hospital can continue to provide quality health care in Jefferson County.”

Mr. Schumer said CMS staff at one point said there is “no method of appeal for a wrong decision and the hospital must absorb the cuts,” according to the news release.

Ms. Kelly said Mr. Schumer’s staff will continue to work on the issue, and will “certainly hope to move forward as quickly as possible.”

Samaritan’s medical education program, which began in 1998, is the only such program within 70 miles.

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