South Dakota hates it when the federal government pays for health care.
Wait: no we don't!
Twenty-six rural hospitals in South Dakota are threatened by a federal agency's proposal that could take away the extra payments they get for service to Medicare patients, a move that might even force some hospitals to close, a state official said.
State Health Secretary Doneen Hollingsworth said the proposal is a long way from being approved, but state officials plan to fight the proposed change in the way rural facilities designated as critical access hospitals are reimbursed for care provided to Medicare patients ["Federal Report Threatens 26 SD Hospitals," AP via Mitchell Daily Republic, 2013.08.29].
The feds are talking—just talking—about re-examining an exception they already grant to South Dakota and other states to designate hospitals within the usual 35-mile limit as "critical access hospitals," which Medicare reimburses at 101% of cost. According to the AP report, the Obama Administration's proposal could kick hospitals in Custer, Winner, Madison, Milbank, and elsewhere out of the critical access category, lowering their reimbursements to Medicare's standard rates. Hospitals keeping critical access status would see their reimbursement drop to 100%.
The Daugaard Administration is ready to fight to keep government hands on Medicare at South Dakota's smaller hospitals, even though the proposed cuts would save Medicare $4 billion. Budget hawkery ends where local politics begins.