"The C-Suite needs to be in communication and have good relationships with local county authorities," says Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance for HCPro, Inc. in Danvers, MA. "Obviously, if a hospital is near a prison, you know you will be treating prisoners, but for other hospitals, you never know if your county sheriff will bring in someone. You need to know the boundaries for who pays what. Get it all worked out in a contract and establish what the rates are."
Hoy recalled a case when an out-of-state patient brought into a hospital by law enforcement authorities subsequently received about a month's worth of treatments for kidney failure.
Ultimately, the man was not charged with a crime. But because he was technically never in the custody of law enforcement, the county was not responsible for his medical charges. The hospital was on the hook for services rendered.
Hoy, who has served as legal counsel for a California hospital, says whoever has the patient in custody pays for their services. Prison inmates are generally not a problem, she says, because they are generally clearly in the custody of the prison.
"Although I did hear of some prisons furloughing prisoners to get expensive surgeries and then re-incarcerating them to get around paying," Hoys says.