Committee presses GDC and Centurion on outside-the-wire care costs and risk‑share audit

Senators used the appropriations hearing to press GDC and its medical contractor, Centurion, for details about off‑site healthcare costs and the contractual risk‑share that allocates a portion of outside‑the‑wire expenses to the department.

GDC staff told the committee that outside inpatient care can cost roughly $4,000 per day and that the proposed FY26 amended request includes about $15 million the department expects to cover as its initial risk share for outside care; Centurion is contractually responsible for other bands of cost. The department and Centurion said they are in year two of the contract and are still reconciling first‑year claims: auditors found missing or unconfirmed data in Centurion’s submission and are requesting supplemental records before finalizing audit results.

Centurion representatives told senators that drivers of rising outside costs include an aging incarcerated population, rising chronic‑disease care needs and the limits of community providers (higher rates demanded for off‑site patient care and the need for security escorts). Centurion and GDC staff argued that admission of a medically intensive in‑house unit (a mod‑core medical unit) would allow more patients to be cared for inside the wire and reduce expensive outside placements.

Committee members asked whether Medicaid or other reimbursement pathways could reduce state costs. Centurion and department staff said federal Medicaid reimbursement is limited for incarcerated populations and that broader benefits would require policy changes or expansion; they also described the practical obstacles to negotiating lower community rates when providers must account for security burdens and nonstandard scheduling.

The subcommittee asked for final audit results, clearer baseline assumptions for future risk‑share calculations and a timeline to resolve first‑year reconciliation.