TRENTON, N.J., June 1, 2016 /PRNewswire/ -- Schutjer Bogar, a leading law firm in Medicare/Medicaid eligibility cases, announced today that it has filed a class action lawsuit against Managed Care Organization (MCO), Amerigroup. Schutjer Bogar contends that the MCO is delaying proper reimbursement on Medicaid claims, costing millions for long-term care organizations.
"The regulations from the Centers for Medicare and Medicaid Services are very clear," stated Chad Bogar, Managing Partner and CEO for Schutjer Bogar. "MCOs must pay 90% of clean claims within 30 days. No exceptions. Unfortunately, when we look at the national landscape, this isn't happening."
According to data from Schutjer Bogar, long-term care organizations, such as nursing homes, assisted living and hospice facilities previously carried an aged Medicaid pending debt of approximately $30-$100 thousand. Now, this figure has spiked to over 1 million due to unpaid, properly-filed Medicaid claims.
"The margins for long-term care providers are already razor-thin," explained Bogar. "When you delay payment and increase their cost of operation, you have the potential to jeopardize the care of residents living at these facilities."
The law firm illustrated this by pointing to one of the participants in the litigation, an elderly nursing home resident that is entitled to almost $30,000 in unpaid Medicaid benefits. Schutjer Bogar states that the MCO is in direct violation of The Federal Medicaid Act by withholding payment. This creates a potentially serious healthcare situation, as the plaintiffs in the suit require 24-hour skilled nursing care.
"This is quite simply a nationwide epidemic impacting our second-most vulnerable population group—our elderly," concluded Bogar.
For more on this story, visit http://www.s-b-b.com/news/details.aspx?id=775.
About Schutjer Bogar
Schutjer Bogar is a law firm with a singular focus on Medicare and Medicaid eligibility cases. While there is one focus, this organization prides itself on delivering three results: Revenue. Recognition. Recovery®. This proprietary system to deliver these results was developed specifically to help long-term care facilities identify new available sources of revenue, specifically from Medicaid and Medicare, to help improve their bottom lines. It's a system that includes internal policies and procedures, contracts, training, and legal services to ensure the best, most meaningful representation for long-term care clients. For more information, visit www.s-b-b.com.
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SOURCE Schutjer Bogar