Editor's Note: In case you have, as I have, been wondering exactly how Sole Community Provider funding works, here's an article explaining it.

Gila Regional Medical Center is in the middle of a controversy, because of a decision to cut 70 employees by 50 percent in hours and pay. The decision has been explained by administration as required because of Sole Community Provider funding having been frozen by the Centers for Medicare and Medicaid, due to a state calculation error in the New Mexico Human Services Department.

This is an explanation of how the Sole Community Provider program works.

What is SCP?

The Sole Community Provider Program (SCP) is a system of payments for indigent patient care to SCP hospitals under a special program in New Mexico's Medicaid Plan, which is a federal/state partnership. The federal share, which provides 75 percent of the funding, is funded by Medicaid dollars. The state's share, 25 percent, is funded by counties via an intergovernmental transfer.


In 1993, a state law was established under the Indigent Hospital and County Health Care Act to be funded by counties, but administered by NM HSD. The SCP Fund is held in the State Treasury. Grant County's money for the SCP Fund comes from the Indigent Fund gross receipts tax.

The amounts available for allocation were initially based on the amount of SCP Hospital claims, as processed and approved by its county for the previous fiscal year. A change, explained later, came in 1999/2000.

The criteria for SCP Hospital designation are based on federal Medicare guidelines in the Social Security Act.

How does SCP work?

The SCP Hospital, which GRMC is so designated for Grant County, makes an annual request for approval by the County Commission by January 15.

The state makes its adjustments and advises the county on its allocated amount to SCP hospitals and that county's quarterly obligations for the fiscal year. The county pays its quarterly obligation and the state matches it with Medicaid dollars.

The state pays the SCP payment directly to the SCP Hospital, usually in the month following the end of the quarter.

The SCP Hospital submits inpatient and outpatient claims to the County Indigent Program for processing on a continual basis, based on guidelines established by each county. In the case of GRMC and Grant County, the claims are processed once a month and approved by the County Commission.
Once the claims are approved, these claims are not paid directly to the SCP Hospital. They are credited against the funds they expect to receive from the SCP program.

For the past few months, County Manager Jon Paul Saari has explained to commissioners that, although the out-of-county claims, which are from facilities outside the county and are generally few in number, are being paid, the in-county claims are not being paid because the SCP funding from the state is not being sent to GRMC.  The state is not receiving the funding from the Centers for Medicare and Medicaid, because, until the alleged error is corrected, the funds are frozen at the federal level.
GRMC was notified of the problem in January, so until then the SCP funds were being received and claims paid for.


In 1999/2000, an Upper Payment Level (UPL) component was added as a one-time, once a year, supplemental payment. The payment is determined by a complex formula managed by the HSD Medical Assistance Division. It is based on the difference between what Medicaid pays hospitals versus what Medicare pays hospitals for the same services. By the calculation, Medicaid pays less than Medicare, so the supplemental payment takes hospital payments "up to" the Medicare level, hence the UPL.

Live from Silver City

Join GCB Three Times Weekly Updates

Welcome to Three Times Weekly Updates! You will be subscribed to email notifications with links to recently posted articles.
You can unsubscribe anytime. We never share or rent your email to anyone.

Fire Alerts

Editor's Note

The Grant County Beat endeavors to post to the Elections page, under News, at the least, notices of candidates for Grant County races. Some candidates for statewide races have also sent their notices. 

The Beat continues to bring you new columnists.Recent additions  include the Christian Corner, for those who are already Christians or are exploring the beliefs.

The second is a business-centered column—Your Business Connection by the New Mexico Business Coalition. The group works to make policy in the state of New Mexico better for all businesses, large and small.

The Beat has a column for you gardeners out there. The Grant County Extension Service will bring you monthly columns on gardening issues. The first one posted is on Winterizing your houseplants and patio plants.

The Beat totally appreciates its readers!  


All articles and photos indicated by a byline are copyrighted to the author or photographer. You may not use any information found within the articles without asking permission AND giving attribution to the source. Photos can be requested and may incur a nominal fee for use personally or commercially.

Don't forget to tell advertisers that you saw their ad on the Beat.

Feel free to notify editor@grantcountybeat.com, if you notice any problems on the site. Your convenience is my desire for the Beat.

We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for us to earn advertising fees by advertising and linking to Amazon.com.

If you subscribe to the Join GCB Three Times Weekly Updates option on the left side of this page, you will be subscribed to email notifications with links to recently posted articles.

Note: This is another component that is in progress of going to a different software to make it easier for you to use and find classifieds that interest you. Check Out Classifieds. And look at Sponsors to see who is helping the Beat.

It's really easy to check to see if there's a classified ad. Just click on Classifieds in the blue menu and the page will open letting you know if there is a classified ad. Remember that your buying classified ads gives you a wide readership, as well as supporting the Beat. Post YOURS for quick results!

Note that if an article does not have a byline, it was sent to the Beat and written by someone not affiliated with the Beat

When you click on the blue and orange button on the upper left side of most pages, you will find out how you can help the Beat defray its expenses, which, with increased readership, continue to grow. You will arrive at a page that gives you options of how you can Help the Beat. All help is greatly appreciated and keeps the news you want and need coming into your browser.

Consider the Beat your DAILY newspaper for up-to-date information about Grant County. It's at your fingertips! One Click to Local News.

Thanks for your support for and your readership of Grant County's online news source—www.grantcountybeat.com