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Clinic reports January FY25 finances; Medicaid rate decision could change outlook
Summary
Clinic staff told the committee that January expenditures are recorded but revenues lag until March; a pending state Medicaid rate increase could generate a retroactive payment the clinic estimates at about $500,000. Committee members discussed a $450,000 municipal budget cut that shifted funds between line items.
On Feb. 18, 2025, clinic leadership presented January fiscal-year-to-date financial reports and told the Skagway Municipality clinic committee that revenues for January had not yet been recorded and will appear in March reporting.
The clinic director said staff met with the borough manager’s office and the treasurer to discuss a $450,000 cut made to the clinic’s adopted budget by the assembly. The cuts affected two lines — contracts and specialists, and the RN (nurse) line — with one line reduced to $0 and the RN line reduced to $150,000; staff moved some expenditures into the salary line to cover existing contracts and nursing costs.
The director said a pending state Medicaid rate increase could be applied retroactively. "The state will go back and look at our fiscal year-to-date Medicaid claims... If the department determines that our rate will be retroactively applied, they will simply cut us a check, basically, for the difference," the director said, adding the clinic estimates a retroactive payment on the order of $500,000 if retroactivity is granted. The director also said if the new rate is not retroactive and instead begins in July, the clinic may face strain and will reassess in July when the state rate takes effect.
Committee member Jen asked how a retroactive rate could be applied after billings had been sent; the director explained that the state adjudicates claims in batches and would pay the difference for January–June claims if retroactivity is approved.
On salaries, a committee member asked why the month’s salary line appeared roughly $26,000 over budget. The director explained that, following the $450,000 cuts, expenses that had been coded to contracts and specialist lines were moved into the salary line to cover existing agreements, which made the salary line appear higher while the overall appropriations remain under review.
Staff also reviewed accounts receivable and collections. The director explained billing timing: charges may be recorded in one month and paid months later by insurance, and clinic collections are cyclical due to Skagway’s large seasonal population; collection activity typically spikes in autumn and winter when the clinic sends delinquent accounts to collections.
Committee members asked for clearer financial reporting, and the director said staff will work on providing more granular presentations as the clinic assumes additional financial control.
