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Medicare head to visit Dickinson

Officials of St. Joseph's Hospital and Health Care Center of Dickinson are hoping to open the eyes of the acting administrator of the federal Medicare and Medicaid programs to the real funding needs of rural hospitals when he visits here tomorrow.

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Officials of St. Joseph's Hospital and Health Care Center of Dickinson are hoping to open the eyes of the acting administrator of the federal Medicare and Medicaid programs to the real funding needs of rural hospitals when he visits here tomorrow.

Sen. Kent Conrad, D-N.D., is bringing Kerry Weems to Dickinson Monday morning to visit with St. Joe's CEO Claudia Eisenmann and her board of directors.

"He's not going to be here very long," Eisenmann said of Weems. "He's coming in the morning to meet with our board, and really, to just listen. To understand what is happening in the Dickinson market; some of the challenges that we face that are unique to our situation."

Earlier this fall, Sen. Byron Dorgan, D-N.D., and Conrad gained a commitment from Senate Finance Committee Chair Sen. Max Baucus, D-Mont., to address the needs of North Dakota hospitals, and St. Joe's in particular. As a result, two specific pieces of Medicare legislation are to be considered by the Senate.

The language specific to St. Joe's addresses its effort to qualify for the Medicare Critical Access Hospitals program which provides enhanced reimbursements. St. Joe's is seeking the critical access designation to help offset about $13.2 million in operational losses it has suffered from fiscal 2002 to the end of the past fiscal year this past June 30. Some estimates have the critical access designation generating an additional $3-$4 million in revenue for the St. Joe's.

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Eisenmann was in Washington, D.C., a few weeks ago to meet with Conrad, Dorgan and Rep. Earl Pomeroy, D-N.D., about St. Joe's funding issues.

"They are working very closely together and very collaboratively, trying to come up with a legislative solution to our problem," she said. "With respect to probabilities in terms of that being achieved, we have to be a bit realistic in that in that, we're asking for a change in federal law. I think we are exceptionally luck that we have these three gentlemen working together on our behalf"

Part of what is going on in Washington, D.C., is the push toward budget neutrality, Eisenmann said. She said the buzzword on Capitol Hill is "pay as you go."

"If there is going to be an increase on the expense side, there has to be a decrease somewhere to pay for it. Or if there isn't a decrease, there has to be some kind of revenue increase," she said. "When you start talking about 'pay as you go,' nobody wants to give anything up."

The challenge in drafting legislation that can benefit St. Joe's is to keep the number of other hospitals that might also benefit from it to a minimum, thereby causing the lowest increase possible in overall additional expense.

St. Joe's is not the only hospital in the state being impacted by Medicare budget cuts or inequities, as hospitals in Williston and Bismarck have announced programming changes in recent weeks.

"Our state, quite frankly, we have some huge challenges facing us, relative to the reimbursement changes, some of which went into effect in October and more of which go into effect in January," Eisenmann said.

She hopes to specifically accomplish two things with Weems' visit here tomorrow.

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"Understanding how pressing the issue is and how important this hospital is to the well being of the community, and not just in terms of health," Eisenmann said of the economic impact the facility has on the region. "Number two, which is equally as important, as a result of the knowledge he acquires from being here, he goes back and supports what Mr. Conrad, Mr. Dorgan and Mr. Pomeroy are proposing."

After his visit to Dickinson, Weems is traveling to Bismarck to have an open forum in the afternoon at the Bismarck Civic Center with medical industry people, Eisenmann said.

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