GMH chief stresses Urgent Care Center is fully compliant - KUAM.com-KUAM News: On Air. Online. On Demand.

GMH chief stresses Urgent Care Center is fully compliant

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 by Jolene Toves

Guam - While things are looking optimistic in the operations of the Guam Memorial Hospital's Urgent Care Center, it is being scrutinized by Vice Speaker BJ Cruz, who wrote a letter to the hospital's management.

Cruz in a letter sent to GMH raises concerns regarding the Urgent Care Center at the hospital questioning its fees for additional services, Medicare and Medicaid reimbursements, and forgone reporting requirements. This letter has left hospital administrator Jospeh Verga "mindboggled", as he said, "First of all, I'm a little confused by Senator Cruz's concerns and I wish he would have called to meet with me before he issued this."

In the letter Cruz noted that the hospital did not comply with a reporting requirement pursuant to Public Law 32-60, however Verga contends otherwise, saying, "The public law required a resolution from the board of trustees and a plan of action well here is the resolution which was approved on the 30th of January 2014 and attached to that resolution was an action plan. Which talks about the site budget all of the requirements according to the law and here is the evidence and the proof that we submitted it to Senator Won Pat's office on February 14, 2014."

Verga says they not only met the 90-day requirement for submission but even early on was meeting those requirements. In the letter Cruz also raises concerns regarding the Centers for Medicare and Medicaid Services' certification status of the new Urgent Care Center and its affect on the hospital's ability to collect Medicare and Medicaid reimbursements for services rendered.

In response, Verga says they are in compliance with all conditions of participation and are CMS certified, saying, "So Senator Cruz's letter is not specific - it does not cite any specific condition of participation with which we are not in compliance with so by all means if he is aware of specific condition of participation please bring it to my attention."

Also questioned were the fees stating, "is the hospital using fees already authorized under the law?".  Verga replied by saying, "As far as fees we met with insurers we had a working group that met with all insurers before we opened urgent care and so we set a fee schedule that was both amiable to them and that was acceptable to us to cover our costs."

He adds that he is not aware of any existing law in which their fee structure is not in compliance with. As for fees for Medicare and Medicaid billing, Verga stresses that they are also in compliance. "We are in compliance with all Medicare laws - if a Medicare patient comes to urgent care we can only charge Medicare rates and that is all we will charge but not everyone who walks in urgent care will receive a Medicare rate," he said.

He says that a fee schedule was approved prior to the opening of the Urgent Care Center. Finally Cruz stated his interest in maximizing the use of preexisting facilities and avoiding redundancy in government services requested Verga share his efforts in coordinating services with the Department of Public Health to which Verga says there is no redundancy because Public Health does not offer urgent care services. He adds that he has been in communication with Public Health since last year as they were a part of the committee which helped develop the Urgent Care Center.

Vice Speaker B.J. Cruz says he will wait to get a response from Verga on his letter before issuing a comment.
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