Erin Jordan from Eastern Iowa Government wrote an article regarding how Iowa taxpayers reimburse nursing homes for legal fees including fees defending abuse and neglect citations. Eastern Iowa nursing homes sought Medicaid reimbursement for more than $2.2 million in legal fees, accounting fees and professional services in 2010. The nursing homes get reimbursement even if they lose citation appeals or lawsuits.
All nursing homes receiving tax funds file annual cost reports requiring detailed information about revenue, expenses, equipment purchases, assets and employee statistics. The cost report allows nursing homes to claim expenses for legal fees. Legal fees are an allowable cost and are included in the calculation of the nursing home’s per-bed, per-day Medicaid reimbursement rate.
The Medicaid division of the Iowa Department of Human Services drafted a proposed rules change in late 2009 or early 2010. The proposal would have forbidden reimbursement for legal fees when a nursing home is defending itself against a criminal or state civil action that it loses or when the Iowa Department of Inspections and Appeals succeeds in suspending or revoking the nursing home’s license. The rules change also would have prohibited reimbursement for legal fees, expenses and costs for lobbying Congress or the Iowa Legislature. No final draft has been published.
Medicaid also reimburses nursing homes for association dues for lobbying groups. Membership dues accounted for more than $950,000 of the Iowa Health Care Association’s budget in 2009, according to the group’s tax report.