Bond(age)

Remember when you were pick pocketed to the tune of $152 Million in 2013?  (http://www.kvia.com/news/UPDATE-El-Paso-County-Commissioners-approve-152-million-bond-issuance/19662796) Of course you do!  The El Paso County Commissioners took it upon themselves to issue a bond to facilitate, among other things, building UMC clinics around El Paso. What we didn’t understand at the time was, why the rush to push the bond through?  Why the rush to build the clinics?  As we’ve done some research, we’ve turned up some interesting things.

In 2011 the Centers for Medicare and Medicaid Services (CMS) approved the State of Texas Medicaid Transformation Waiver under Section 1115 of the Social Security Act. This is a 5 year waiver (expiring in September of 2016).  This waiver was intended to allow Texas “expand Medicaid managed-care programs across the state, preserve hospital funding by assisting providers with health care costs that are currently uncompensated, and provide an incentive payment pool for the redesign and implementation of performance improvements in health care delivery systems.” (emphasis added) (http://tamhsc.edu/1115-waiver/).   This means that hospitals that implement improvements (i.e. new health clinics around town) would be able to draw more money down from the government until September of 2016.  For those of you who have been following the EPCH/UMC arguments over rent this might sound very familiar.  EPCH claimed that rent was a means for UMC to draw down more IGT (Intergovernmental Transfer) funds (http://www.kfoxtv.com/news/features/top-stories/stories/El-Paso-Children-39-s-Hospital-owes-2-3-million-to-UMC-201899.shtml#.VjzLKrerQuU).  Are these clinics just another variation on that theme?  What happens when those waivers expire next year?  We predict that the El Paso Tax Payers will once again watch their money disappear as UMC and the County Commissioners scramble to ‘save the clinics’.

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