CHARLESTON, W.Va. -- A Beckley-based hospital cannot challenge its Medicaid reimbursement rates because it doesn't have a statutory basis to do so, West Virginia Supreme Court justices recently ruled.
Appalachian Regional Healthcare, doing business as Beckley ARH Hospital, filed the 2010 case in Kanawha County Circuit Court against the West Virginia Department of Health and Human Resources, Karen Bowling, the West Virginia Bureau for Medical Services and Nancy Atkins.
In its suit, Beckley ARH alleged it didn't receive an adequate amount of Medicaid reimbursements to cover all its patients.
According to the opinion, Beckley ARH said it incurred $14.7 million for treating Medicaid patients but only received $11.9 million in reimbursements. The suit also alleged the department didn't set an adequate reimbursement rate.
In an agreement with the Bureau of Medical Services, the hospital agreed to be a Medicaid provider but specific rates were not included in this agreement, the opinion states. The agreement also didn't say the hospital would be reimbursed for all its Medicaid costs.
The Beckley hospital sought a writ of mandamus, requiring the department to give it an adequate reimbursement rate, the opinion states.
The lower court granted the department's motion to dismiss, determining Bar-H didn't establish a claim that relief could be granted.