DOC tells Senate panel outside‑the‑wire care is rising; Centurion risk‑share and audit reconciliation flagged as next steps

During the appropriations subcommittee hearing, DOC leaders and health‑care contractors detailed rising costs for off‑site inpatient care and plans to expand in‑house infirmary capacity. DOC said it included the FY26 amended request of about $38.8 million to cover outside‑the‑wire care tied to Autry, McRae and Johnson State Prison projects that add inpatient and skilled‑nursing capacity.

DOC told senators outside inpatient care can cost roughly $4,000 per day per inmate, and that the department has experienced growing expenses tied to an aging and more medically complex incarcerated population. "It's roughly costing us $4,000 per day per inmate that we have, that we can't bring back inside the wire for infirmary care," a DOC presenter said.

Representatives from Centurion, DOC’s medical contractor, described a multi‑tiered risk‑share arrangement: a $60 million attachment in year 1, then the department’s responsibility for the next $15 million, with a 50/50 split for claims above $90 million. Committee members asked about missing data in the audit of the first year’s claims; DOC said auditors flagged missing documentation that Centurion must supply so rates and claims can be verified. Centurion and DOC said they are cooperating on the audit and expect additional reconciled data in short order.

Committee members also discussed strategies to reduce off‑site costs, including development of ModCor medically intensive units to treat patients inside DOC facilities and potential Medicaid or policy solutions used in other states. DOC and contractors said building in‑house capacity could allow more continuity of care, lower per‑patient costs and reduce reliance on expensive community inpatient placements.

Senators asked DOC and Centurion to return with the outstanding audit reconciliations and detailed cost and utilization data before finalizing budget decisions. No vote occurred at the hearing; members underscored that improved data will shape whether supplemental funds are approved.