Brady, a county department head, told Madison County supervisors the county is monitoring federal and industry changes that restrict sending medical-billing accounts to credit bureaus and require more extensive documentation when collection agencies contact patients. Brady said these changes make the collections process more labor-intensive because each attempted contact must be documented and validated with billing records.

Brady explained the county's Medicaid-billing add-on rate for the coming year is $1,716.35 and noted the county's portion of related revenue items (a figure of roughly $51,007.15 was cited in the meeting for one component), with federal portions and other reimbursements referenced by staff. He said the county has seen increased collections after moving to a new medical billing company and that the change in federal rules may reduce the effectiveness of some debt-collection practices.

Brady also reported that the county held a rural trauma development course with Mercy Hospital and Madison County Hospital and ran a car-seat installation class on Dec. 4 with 14 participants and five certified technicians available for community checks. He told supervisors the state auditor had identified delinquencies tied to a single staff member handling mail and recommended separation of duties, a challenge in a small office.

Board members asked follow-up questions about whether city and rural ambulance revenues differ and about reconciliation of a new HSA fund; finance staff said month-end cannot be closed until HSA transfer mismatches are resolved.

Brady said the county will continue to track federal guidance and work with its billing contractor to adapt procedures.