As of Friday, both the House and Senate have signed off on House 221, which gives approval for the University of Wyoming to outsource the management of its Family Medicine Residency Clinics in Cheyenne and Casper.

Only four legislators voted against the bill and none spoke against it on the floor of either chamber.

Before the bill heads to Gov. Mark Gordon’s desk, the House still needs to sign-off on one some minor language tweaks made by the Senate.

The bill will allow UW to contract the day-to-day operations of the hospitals to a private nonprofit while continuing to use state dollars to pay medical residents and the clinic’s faculty.

After former Gov. Matt Mead requested in 2012 the clinics reduce their reliance on the general fund, they have received increased Medicaid-and Medicare-related reimbursements after becoming designated as a Federally Qualified Health Center. That status is, however, in jeopardy because of the managerial structure.

When Rep. Bob Nicholas, R-Cheyenne, introduced the bill to the House floor, he said keeping the clinics’ federal status intact is imperative to prevent reversion to a time when “this program was gobbling up a lot of general fund dollars and growing.”

Before earning the status as a Federally Qualified Health Center, the clinics earned about $150 in Medicaid reimbursement per visit. Now the clinics get about $350 per visit.

The increased reliance on federal requirements means more federal requirements, including having a community board. The clinics are currently overseen by the Educational Health Center of Wyoming.

However, federal auditors have threatened to cut off funding because that board doesn’t have significant control over the clinics’ budgeting or federal funds.

The proposed privatization would aim to retain that funding by handing over managerial control to the community board.

UW will still need to bring the final contracts to the Joint Appropriations Committee for approval.

Clinic revenue is now expected to be $16.7 million during the 2019-2020 biennium, up from $10.7 million in the 2015-2016 biennium. With the increased federal reimbursements, clinic revenue is now 51 percent of the clinics’ budget. A third, smaller clinic, is operated in Laramie but it does not receive state or university funds.

Sen. Fred Baldwin, R-Kemmerer, told the Senate this week a fourth clinic in Thermopolis is being developed.

“That’s just a potential right now, and there’s some potential for more down the road,” he said.

The residency clinics serve future doctors from across the U.S. and world. Considering that the clinic doesn’t cater to Wyoming residents, Baldwin said it’s “icing on the cake” that more than 30 percent of residents who attend UW’s clinics stay to practice in Wyoming.

“They come here and say ‘I like the snow. I like the icicles. I like the wind.’ Or maybe the road’s closed and they can’t get out. I don’t know,” Baldwin joked.

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