Doctors Being Paid By Government May Soon Be Required To Accept Medicaid

ST. CROIX — At a Senate hearing held by the Committee on Health, Hospital and Human Services on Wednesday, senators unanimously supported three measures and forwarded them to the Committee on Rules and Judiciary for further vetting.

Among the measures was bill No. 31-0294, sponsored by Senator Nereida Rivera-O’Reilly — first introduced by the senator in the 30th Legislature — which, if signed into law, would require that all physicians who are employed at the territory’s hospitals, yet work at private facilities and receive financial assistance towards their medical malpractice insurance premiums, to accept Medicare and Medicaid. Currently, physicians that are part of the program with the territory’s hospitals receive $100,000 annually to be on call at all times, according to Roy Lester Schneider Hospital CEO Bernard Wheatley, who testified at the hearing, held at the Fritz E. Lawaetz Legislative Hall.

Mr. Wheatley and others, including Commissioner of Health Nominee Michelle Davis, expressed concern with the measure. Mr. Wheatley said the measure punishes physicians who work for the hospitals but it does not address those engaged solely in private practice — hence placing them in a disadvantageous position against their privately-employed counterparts. Because of this, he said, doctors working at the hospitals may be discouraged to continue in the program.

But Mrs. Rivera-O’Reilly said it was the right time to reintroduce the measure, as Medicaid and Medicare participation has grown from 5,000 to nearly 20,000 residents, an increase attributed to the federal expansion of Medicare and Medicaid under the Affordable Care Act, also called Obamacare. Mrs. Rivera-O’Reilly, who has said the time has come for her to leave the Legislature, said it had become very costly for residents to travel out of the territory and head to the mainland for care, which in turns causes millions of federal dollars to escape the islands and be spent elsewhere.

Even so, Ms. Davis, while seeing the need for change, expressed concern with the latest measure, and highlighted that out of 275 providers, only three were not participating. And part of the problem appears to be bureaucracy at the Department of Human Services, which includes as part of its duty the enrollment of providers into the federal programs. V.I. Esquire Director Dynel Soto said her company had entered into a contract with D.H.S. to aid the government department in enrolling healthcare providers into Medicare, but as far as she knew, following the expiration of the contract in 2013, D.H.S. had yet to enroll a single new provider.

D.H.S. Commissioner Vivian Fludd admitted that issues with enrollment have prevailed at the department, but she contended that progress was being made as a new firm had been contracted to aid with new recruitment. And she revealed that in fiscal year 2013, D.H.S. had 139 Medicare providers, a number that has increased to 419 since then to keep up with the expansion of Medicaid.

Another measure, bill No. 31-0324, sponsored by Senator Kurt Vialet and aimed at allowing medical practitioners in the private sector to apply for temporary licensure in the territory, had more opponents than a proponents. D.O.H. and hospital officials said the measure would drain an already financially struggling hospital, and transfer those funds to physicians in private practice. They also argued that such a law would diminish the advantage that the hospitals currently hold in attracting new physicians.

The measures were forwarded to the Committee on Rules and Judiciary without opposition, as lawmakers said amendments would be added to allay concerns.