Judgment Against Oklahoma Care Homes
A judge of the Oklahoma County has ruled that the Oklahoma Health Care Authority is not under-funding the nursing homes of Medicaid reimbursements. The ruling was in response to lawsuit that was filed in 2004 by three nursing homes that claimed that the Medicaid reimbursement rate of the health care authority does not meet the cost of care meted out to patients. The case got class action status in 2008 while the nursing homes sought damages worth to the tune of $200. The ruling quashed the class action lawsuit, that if had been passed in favor of the nurse would have cost the state exchequer millions of dollars.
The ruling by the District Judge Dan Owens last week stated that the state agency had not violated its agreement made with the nursing homes while the rates of reimbursement met all federal and state requirements.
The attorney of the nursing homes, David Cole later said that they would go for an appeal.
It was said that the Oklahoma Health Care Authority through its Medicaid program regularly pays about 70 percent of cost involved in the care given in all the nursing homes in the state. It needs to be mentioned here that the total cost of Medicaid program is funded with 70 percent of federal funds while the rest 30 percent comes from state dollars.
Presently, 303 nursing homes are there in Oklahoma that contract with the program. All of them jointly brought the lawsuit against the authority to ask them to pay back till 2001.
On the part of the nursing homes, it is claimed that the rate of reimbursement is not enough to cover the rising cost of care and as a result is leading many nursing homes to down their shutter. According to attorney Marjorie Galt, who is the co-counsel for the nursing homes said that the authority is not calculating the rate of reimbursement every year as is necessary by the law.
Galt said that they are still waiting for the day when their point would be proved. They are looking for a jury to decide their case. Attorney Howard Pallota, who is the director of legal services of Oklahoma Health Care Authority, said that since 2000, the Medicaid reimbursement for nursing homes have increased to about 94 percent.
Pallotta said that in 2000, the reimbursement for nursing homes were $67.75 a day made to every Medicaid patient. In October this figure went up to $120.55$ to $136.33 a day.
He said that it is the occupancy rates with which the closures were more likely linked. He further added that as the rates went up, the occupancy rates came down. These nursing homes do not have enough customers. The state too does not feel obliged to take care of empty beds.
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