News & Record
RALEIGH, N.C. — The state Department of Correction is obligated to provide medical care for prison inmates. But it also has an obligation to taxpayers to rein in out-of-control costs.
A report by State Auditor Beth Wood’s staff last week concluded that demanding tougher DOC oversight and accountability would save tens of millions of tax dollars.
The prison system, the report contends, pays almost five times, on average, what government-funded coverage does for the same level of patient care. Last year, the state reportedly spent $231 million on all prisoner-related health expenses.
A DOC official told The News & Observer of Raleigh, “We don’t have the expertise within our system to negotiate these contracts.” Nor, it is claimed, does the system have the necessary “leverage” to make deals.
As a result, auditors found that in the most egregious examples of waste, the state was billed by participating hospitals, on average, at 467 percent of reimbursement rates for Medicare and Medicaid patients.
To their credit, legislators did respond. As last summer’s session was winding down, the General Assembly passed a budget bill requiring that hospitals and doctors be paid according to the state employee health insurance plan rate structure, which would have resulted in much lower across-the-board costs.
However, plan administrator Blue Cross Blue Shield of North Carolina questioned its legality. Then-Senate Majority Leader Tony Rand reportedly responded by inserting a clause in an unrelated bill, effectively overriding the money-saving effort.
Exactly what happened then remains fuzzy. Yet it’s perfectly clear now that the General Assembly and Gov. Bev Perdue must act quickly to cap out-of-control inmate medical costs.
As the state’s prison population grows and ages, health care will become an even more pressing issue. Lengthy sentences mean more inmates needing medical care will be spending their golden years behind bars.
DOC will have to provide more and better on-site health and custodial services or seek it elsewhere, but at a reasonable cost.
Some states, as a cost-cutting measure, have even resorted to granting early parole to sick or infirm inmates, shifting treatment expenses to Medicare, Medicaid or their families.
Yet such deception merely passes the burden along to someone else. Instead, the DOC, hospitals and insurers must work together on containment measures that provide both appropriate care and equitable reimbursement.
For now, that’s not happening. And as it stands, the state’s taxpayers are the biggest losers.
* The bill for treatment, now in the millions of dollars, will continue to escalate unless the state takes steps to negotiate more reasonable rates.
Copyright 2010 News & Record (Greensboro, NC)