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Nursing homes, patients win debt payments in Medicaid settlement

Baltimore Sun, by Meredith Cohn

Thousands of low-income nursing home patients in Maryland will have millions in old debts wiped out now that the state has settled a years-long case involving Medicaid payments.
[...]
The money was about a quarter of what the nursing homes said they were owed from 2002-2005, when Smith and others filed a class-action lawsuit in Baltimore Circuit Court.

But perhaps more important than the one-time payment, he said, is the change in obscure state Medicaid rules that will aid future nursing home patients and could become a road map for other states. Those rules govern how — and when — a patient is required to make a co-payment for nursing home care.

In order to qualify for Medicaid, the federal-state program for the poor, an individual must deplete his or her assets to reach a $2,000 threshold. Often, that patient needs care before reaching that limit and can accumulate thousands of dollars in nursing home bills.

According to the federal Centers for Medicare and Medicaid Services, which oversees the program, Maryland and other states had been calculating a patient’s contributions incorrectly all along. They had been requiring all Medicaid recipients in nursing homes to make co-pays regardless of their old debts.


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