Motion to Dismiss Denied in Illinois Medicaid Application Backlog Cases
Federal judge rules in favor of long-term care providers proceeding with legal action against Director of the Illinois Department of Healthcare and Family Services
CHICAGO, June 9, 2017 /PRNewswire/ -- A federal judge ruled that 7 complaints can move forward involving over 150 long-term care facilities and the current Medicaid application processing backlog in the State of Illinois. The judge denied a motion to dismiss filed on behalf of Director of the Illinois Department of Healthcare and Family Services ("HFS"), Felicia Norwood. This pushes the matter to a conference to discuss the scope of an injunction against Illinois HFS, scheduled for today.
sb2 inc., a leading law firm in Medicare/Medicaid Eligibility and Reimbursement representing the facilities, hailed the decision as validation of the plaintiffs' legal standing to pursue the matter. "The Medicaid backlog in the State of Illinois directly impedes the ability for these facilities to care for their residents," stated Chad Bogar, Managing Partner and CEO for sb2 inc. "This ruling is an acknowledgement that the facilities are representing their residents' interests in trying resolve the issue and protect quality of care."
The complaints arise from a backlog of approximately 7000 cases pending Medicaid review in the State of Illinois. These cases typically involve seniors that do not have the ability to pay for long-term nursing home care, and do not have the personal assets to cover care expenses. Federal law requires that states process Medicaid applications within 45 days, but according to Bogar, some of these applications are delayed a year or longer.
The complaints allege that the backlog is due in part by a failure of Illinois HFS to use an electronic asset verification program (AVP) to determine eligibility for Medicaid in a timely fashion. "Congress passed a law in 2008 that clearly defines that states must implement an AVP system," said Bogar. "The state is not trying to obtain resident information through AVP, and they are not accessing the information through other sources. This puts residents at risk of losing their ability to stay at a facility and receive care."
With the latest ruling, sb2 inc hopes to move these cases towards a quick resolution and compel the State of Illinois to start using AVP to shrink the backlog of applications.
About sb2 Inc.
sb2 inc. has a core philosophy aligned squarely with our clients' commitment to protect their elderly residents. To achieve this, the firm developed an approach to consider the entire network of variables that impact the revenue of long-term care facilities, and created the Revenue.Recognition.Recovery.® system to address every one. This proprietary system helps facilities to identify newly available sources of revenue—specifically from Medicaid and Medicare—to help build bottom lines. The system includes touchpoints such as internal policies and procedures, training, and legal services. sb2 inc. service offerings expand even further with partnerships that now enable the firm to offer RevenueNova: a broad scope of full-service, back-office support from initial referral straight through to billing. Long-term care facilities that aggressively use all of these revenue sources are the ones that will chart their growth well into the future. For more information, visit www.sb2inc.com.
Contact:
Chad Bogar
212-203-1334
[email protected]
SOURCE sb2 Inc.
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