Illinois Nursing Homes Gripe Over Medicaid Cuts

CHICAGO (CN) - Illinois cut Medicaid reimbursements for two skilled-nursing facilities by 12.6 percent rather than the 2.25 percent state lawmakers cut from the Medicaid fund, the facilities claim in court.

Evanston Nursing & Rehab Center, which does business as Aperion Care Evanston, and Glenbridge Nursing & Rehabilitation Centre sued the Illinois Department of Healthcare and Family Services, Director Felicia Norwood, and Acting Medicaid Director Teresa Hursey in Cook County Court.

Plaintiffs provide skilled-nursing services to Medicaid residents, and are reimbursed by the state for the cost of care. Aperion has 57 Medicaid beds, while Glenbridge has 302.

The Illinois Legislature originally appropriated nearly $1.7 trillion to skilled-nursing facilities for fiscal year 2015. The Department of Health Services receives the largest portion of the general-fund budget of any Illinois state agency.

But due to Illinois' budget shortfall, lawmakers cut Medicaid appropriations by 2.25 percent towards the end of fiscal year 2015.

In response, the Department of Health and Family Services (HFS) reduced reimbursement rates for skilled-nursing facilities even further - by 12.6 percent, effective May 1, 2015 to June 30, 2015 - reducing Medicaid appropriations further by $35 million.

"HFS cut payments to skilling-nursing facilities for services rendered in May and June 2015 by approximately $13.3 million more than the cut than Public Acts 99-0001 and 99-0002 authorized," the complaint says.

Aperion received a payment for Medicaid services of $180.62 per diem in April, but just $157.86 per diem rate in May. Glenbridge received a per diem of $168.91 in April, but only $147.63 in May.

Plaintiffs seek a court declaration that HFS was only permitted to reduce reimbursement rates for 2015 by 2.25 percent to match the reduction in the general fund.

"HFS has acted without proper statutory authority in promulgating an emergency rule reducing SNF Medicaid reimbursement rates by 12.6 percent for May 1, 2015 to June 30, 2015," the complaint claims.

The nursing facilities are represented by Dayna LaPlante with Polsinelli PC.

Illinois is still without an approved state budget, since Governor Bruce Rauner, a Republican, vetoed most of the Democrat-controlled Legislature's budget plan on June 25. He signed only portions of the bill to allow education funding to continue.

Democrats acknowledge their plan is more than $3 billion short on revenue, but refuse to hobble organized labor or make the drastic social-service cuts demanded by Rauner.

Last month, a judge ruled that tens of thousands of state employees cannot receive their full paychecks until lawmakers approve a 2016 budget. However, the governor's staff and legislators continue to receive their full salaries.

According to a study performed by the Mercatus Center at George Mason University, Illinois is in the worst fiscal health of all 50 states.

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