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Life Health > Health Insurance > Health Insurance

H.R. 3587: Lawmakers Call for Medicaid Plans to Pay LTC Providers Faster

By Allison Bell

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Rep. Anna Eshoo, D-Palo Alto, Calif., and Rep. Brian Bilbray, R-San Diego, have joined forces to introduce H.R. 3587, a bill that would set prompt-payment standards for nursing homes and other facilities that take Medicaid.

H.R. 3587, the Fair Pay to Medicaid Providers Act bill, would require state Medicaid plans to pay facilities about as quickly as they pay physicians, according to the bill text.

Federal law requires Medicaid plans to pay 90% of physician services claims within 30 days and 99% of physician services claims within 90 days. The requirements do not apply to facilities.

“Our health care professionals and facilities deserve to be reimbursed in a predictable and consistent timeframe,” Eshoo says in a statement about the bill.

Bilbray says payment delays can put patients at risk, by making it difficult for facilities to pay and keep emloyees.

In California, for example, a budget battle that took place in 2008 forced some long-term care (LTC) facilities and other facilities to go without payments for 60 says, the lawmakers say.

Owners of some facilities had to borrow against retirement accounts or mortgage their own homes to continue to make payroll, the lawmakers say.

Jim Gomez, the president of the California Association of Health Facilities, Sacramento, Calif., is praising the bill. He notes that Medicaid facility prompt-payment requirements could have an especially big impact in California, because California has gotten only 5 budgets signed on time in the past 16 years.

The American Recovery and Reinvestment Act of 2009 (ARRA) provided a temporary prompt-payment provision for LTC facilities and other facilities that take Medicaid, but funding for that provision ended July 1, Gomez says.

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