The Medical College of Georgia Hospital and Clinics has established new guidelines to help limit an increasing number of "inappropriate" referrals for indigent care, officials said.
Under the new guidelines, approved late last month by the hospital's board, the 461-bed medical center and its clinics, based in Augusta, may restrict primary-care patients to those who live within 50 miles or an hour's drive. Referring physicians also must agree to treat the patient once the hospital care is completed. The guidelines also detail the "level of communication needed" between a referring physician and an accepting physician, said Don Snell, the organization's president and chief executive officer.
The teaching hospital, a private, not-for-profit facility after being spun off from the University of Georgia board of regents last July, has provided about $100 million in charity care each of the past five years, serving indigent patients in all of the state's 159 counties, Snell said. He said some patients are traveling 200 miles or more to the hospital for primary care.
"It's not a radical departure," Snell said of the guidelines, calling them a slight revision of existing rules. "What it does is clarify how we will handle this indigent population."
In fact, Snell said, hospital officials are tracking about 15 to 20 "rather obviously inappropriate" referrals that could be violations of the Emergency Medical Treatment and Active Labor Act. He said about 80 hospitals in the state receive federal indigent-care trust fund money, suggesting that his institution may be receiving more than its fair share of charity cases.
Snell said the organization isn't trying to limit indigent care, and he expects the hospital to treat about the same number of indigent and uninsured patients under the revised guidelines.
"Our focus always has been and always will be: What is the most appropriate care for the patient?" he said. "Is traveling 200 miles for primary care, when there are primary-care facilities in that patient's community, good care?"