by John E. Dannenberg
Settling a long-simmering dispute in billing rates for medical treatment of jail prisoners, San Diego County has agreed to pay $1.5 million to multiple hospitals for bills dating back over three years. The health care providers had sued the county in 2004 to recover unpaid bills incurred by its Sheriff's Department. The agreement does not cover some emergency room doctors who have sued separately.
State law requires sheriffs to pay for medical care for their jail prisoners. To this end, the San Diego County Sheriff contracted to pay specified rates for prisoner care, but in 2003 unilaterally notified the hospitals that he would now only pay a lesser scale. The hospitals responded by submitting full-billed charges, which the sheriff proceeded to underpay. The full-billed charges came to $5 million. The settlement now calls for the county to pay $1,457,717 to the involved hospitals, on top of the $700,000 paid earlier.
The agreement permits the county to appeal one remaining question, namely whether the sheriff is responsible for medical costs of pre-arraignment detainees. The San Diego Superior Court ruled in October 2005 that the county is so obligated. [Note: Reversal of this holding would have the anomalous result of insulating the sheriff from liability for injuries wrought upon a detainee during his arrest -- a distasteful prospect in stark tension with the presumption of innocence.] Billings for such detainees in the last two years approach $4 million. The county has agreed that if it loses its appeal, it will pay 55% of these full-billed charges.
Separately, a dispute with Tri-City hospital emergency room doctors for unpaid prisoner bills is set for trial in August, 2006. They filed a second suit on April 18, 2006 for bills from a different time frame.
A new law on health care provider reimbursements by county sheriffs was enacted October 4, 2005 (Senate Bill 159) and provides, inter alia, that hospitals providing emergency medical care, but who do not have a contract with the sheriff, may charge only a rate equal to 110% of the hospital's actual costs. San Diegos sheriff currently has only one contracted provider, the University of California Medical Center.
Source: North County Times.
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