MOULTRIE — Budget issues will dominate lawmakers’ time under the gold dome during the 40-day legislative session, with the resolution of Medicaid funding among the issues having a significant impact on rural hospitals.

If a hospital fee, commonly referred to as the bed tax, is not renewed, rural hospitals could see a reduction of 20 percent in Medicaid revenues, state Rep. Sam Watson, newly seated in District 172, said during his first week at the Capitol.

Elimination of the provider fee  — 1.45 percent of hospital charges — would result in a reduction of $235 million in money earmarked for Medicare programs in the state budget, money that is used as a match that brings in $454 million in federal funds, a nearly 2 to 1 leveraging of state collections.

Gov. Nathan Deal has proposed shifting collection of the revenue to the Department of Community Health.

“It would mean a 20 percent reduction in revenues for hospitals, especially small hospitals,” Watson said. “Hospitals in communities like ours are some of our biggest employers, so we don’t want to lose the funding.”

Watson, a Republican elected in November as the first Colquitt County resident to hold a state representative seat since C.J. Powell in 1992, said that hospital officials who attended hearings mostly have been supportive of Deal’s proposal. The reconfiguration of House districts split Colquitt County nearly down the middle, with Jay Powell, R-Camilla, in District 171. District 172 also includes a portion of northern Thomas County and southern Tift County.

CRMC collected $943,767 in provider fees turned in to the state for the fiscal year that ended Sept. 30, hospital CFO Larry Sims said.

During the same year the hospital received total Medicaid reimbursements of $12.42 million and incurred Medicaid costs totaling $12.5 million, he said. The difference between the amount received and that spent on care was written off.

A reduction in Medicaid dollars would have a large impact on patient care, said Jim Matney, CRMC president and CEO. As it is, Medicaid pays doctors 29 cents on the dollar in reimbursement, an amount that would be reduced without the state match that brings in federal matching funds.

“Currently the hospital has a hard time in getting doctors to participate in Medicaid,” he said. “Without this bed tax, they’re going to be forced to reduce patients on Medicaid.”

Legislative approval to transfer collection of the fees to Community Health will allow the state to continue Medicaid payments to hospitals for the next five years.

“What it does, it allows us to keep the current reimbursement in place and not see a reduction,” Matney said.

Without its renewal “you’re going to see doctors stop taking Medicaid,” he said.

If patients currently receiving medical services through Medicaid are unable to continue doing so, they likely will show up at hospital emergency rooms. Emergency-room care is significantly more expensive, and patients on Medicaid would be less able to pay for treatment in that setting.

Another issue that Watson said is among the governor’s priorities is reform of the juvenile justice system.

Watson, appointed to the newly established Juvenile Justice Committee, said that after reforms last year meant to reduce the number of non-violent prisoners in the state’s system, the emphasis this year will be on reducing costs and improving outcomes in its juvenile counterpart.

“The governor mentioned this in his State of the State address,” said Watson, who also was appointed to the Agriculture and Transportation committees. “I think it’s going to be a very important committee. It’s important that we work with our kids to keep them out of trouble and out of jail.”

Watson said he also hopes that the Transportation Committee will give him a voice in advancing the project to four-lane Georgia Highway 133 from Albany to Valdosta. The road has received funding for surveying and acquisition of right-of-way for a portion of the route.

“That’s definitely one of the projects I’ll be looking into,” he said.

With most districts voting down last year’s one-cent transportation tax, legislators will have to go back to the drawing board to figure out a means of improving the state’s roadways.

“With agriculture being our largest thing in our area and number one in the state, I was very excited at being on that committee,” Watson said.