Gov. Harry R. Hughes said he will ask the 1981 General Assembly for a special $12 million allocation to bolster Maryland's ailing Medicaid program and stave off hardship for the state's poor who need medical care.
The governor's request is expected to be included in the budget proposals he will present to the assembly this month. It follows cutbacks in Medicaid services that took effect Jan. 1 after state health officials predicted an $80 million loss from burgeoning Medicaid Medicaid costs incurred by the state's 376,000 indigent patients.
With or without the governor's help, Prince George's is expected to be the hardest hit county in the state, said John Folkmer, acting chief of planning for the state Department of Health and Mental Hygiene.
Prince George's has the second highest Medicaid enrollment in the state with 35,562 eligible patients; its county hospitals may lose $2 million this year if the assembly does not approve Hughes' bail-out proposal.
Montgomery County, by comparison, reported 19,181 Medicaid recipients in fiscal 1980. Baltimore City is ranked first in medical aid to the poor with 206,000 patients on the 1980 rolls.
If the General Assembly fails to provide the financial aid, Maryland hospitals will have to ask the state health care review commission for a rate increase.
"That means that other patients will have to pay for the cost of care for the poor," said Robin H. Hagaman, administrator for Prince George's General Hospital and Medical Center.
The last alternatives, he said, include increases in health care subsidies from county governments, medical service cutbacks or the elimination of health care jobs.
The new cutbacks, unanimously adopted in December by an emergency session of the legislature's joint House and Senate administrative, executive and legislative review committee, are being assailed by Prince George's County and local health officials who say the state is taking the wrong approach.
"Their actions are arbitrary and pick on the medical patients who are the sickest," said Hagaman.
His anger is directed chiefly toward the new rule which discontinues Medicaid support for patients after 20 days in the hospital. "These are the (patients) who need it the most-the coronary care patients, the pre-natal care cases and people who need psychological care," Hagaman said.
The Medicaid service changes affect two other categories of health care: pre-operative treatment and surgery.
According to Audrey Scott, the mayor of Bowie and director of community relations at Prince George's General, Medicaid will pay for only one day in the hospital before surgery. "This is ridiculous," said Scott. "The sickest patients are the ones who need to come in for two or three days of tests before being operated on."
The rest of the state-mandated changes apply to more than 200 surgical procedures which Scott said will no longer be covered if they are performed outside a doctor's office. Scott said the ruling is aimed at encouraging out-patient care in physician's offices, rather than in hospitals, for minor surgery.
Said Hagaman, "We don't have any real problems except for the 20-day limit on how long a patient can stay. It won't affect the treatment the poor people receive. They are not going to be denied the care if they need it. But it will matter in terms of who pays for it," he said. "That's the bottom line. Someone has t pay for it. There is nothing free in this society."
Hagaman said area hospitals are being hit by a rapid increase in Medicaid patients and complained that the worst crunch is being felt in the state's five trauma centers -- one of which is Prince George's General, which has kidney dialysis and coronary care units. The presence of the units funnels is disproportionate number of poor patients who are very sick into Prince George's General, Hagaman said.