Several media outlets have reported the $16 million settlement between Maryland and the nursing home industry including Consumer Affairs, The Baltimore Sun and the Washington Post.  Nursing homes sued Maryland for more money.  The average monthyl rate Medicaid pays for nursing home care is over $6,000.  The class action lawsuit, filed in August 2005, claimed that the state’s Department of Health and Mental Hygiene erroneously concluded that nursing home residents could afford co-payments for their care. That determination failed to take into account the debt that patients accrued while waiting to be approved for Medicaid coverage, according to the suit. Federal and state law requires states to consider patients’ debt when calculating their income.

Maryland taxpayers will provide $8 million of the settlement funds, with the federal government paying the other half. Nursing homes claimed that the state owed $64 million for incorrect calculations made since 2002.

The settlement could serve as precedent for other states that fail to take patients’ old debt into account when determining their Medicaid eligibility. 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.

Consumers can obtain information at the official settlement website

 

 

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