NURSING HOMES RESPOND TO MISCHARACTERIZATION IN UHIP SAGA
PROVIDENCE, RHODE ISLAND, April 5, 2019: In response to a news report today that mischaracterized their industry, nursing home leaders strongly denied being unresponsive to state billing errors.
The April 5 edition of the Providence Journal claimed that state officials are “chasing’” nursing homes for repayment of $60.8 million that was advanced to them, and indicated that nursing homes have been unresponsive. According to the leaders of two healthcare associations representing 83 nursing homes in the state., the article inaccurately depicts the financial situation and the industry’s responsiveness to the State.
Scott Fraser, president and CEO of the Rhode Island Health Care Association (RIHCA) and James Nyberg, director of LeadingAge RI, dispute the characterization that nursing homes have been unresponsive to the state in its quest to recoup double payments for Medicaid reimbursements, and assert that nursing homes are not holding state money.
“In fact, because of the UHIP debacle, nursing homes are owed tens of millions of dollars in Medicaid payments from the State of Rhode Island. These interim payments that were referenced in the article are what is keeping many senior care organizations financially afloat while they await payments from application delays and billing issues caused by the UHIP fiasco. This false depiction of our industry is extremely frustrating,” said Nyberg.
“What’s at stake? Care of our frail elders,” asserted Fraser. “Some of our homes are still owed hundreds of thousands of dollars in payments for pending Medicaid claims. Yet, we are still being asked to repay money that the flawed UHIP system paid out to us in error. It makes for a precarious financial situation,” he added.
The most recent data from EOHHS shows that there are 1,079 backlogged Medicaid applications, including 150 that have remained stalled in “pending” status in excess of one year. Once approved, additional billing hurdles must be overcome before reimbursement checks are actually sent. UHIP has disrupted the financial ecosystem of the entire nursing home industry in unprecedented fashion.
“Nursing homes are committed to providing uninterrupted, compassionate care and services to frail seniors -- even if the state is almost a year overdue in paying its bills. We have not evaded responsibility for repayment of our debts; we are the responsible financial agents here,” said Nyberg.
“While we acknowledge overpayments to some providers, we are refunding that money through a state-approved repayment plan. We are willing to work with the State to come up with a way to accelerate this process. However, we have to make sure that both sides can agree on the amount owed for each claim before repayment can be made,” added Fraser.
The two leaders also agree that nursing homes in Rhode Island should be given credit for patiently waiting for the UHIP resolution. “Two plus years is long enough. We have worked with limited resources to ensure continuity of care for the families who have entrusted us with their parents and grandparents,” concluded Nyberg.
About LeadingAge RI
LeadingAge RI (leadingageri.org) was founded in 1989 and represents a continuum of over long-term care providers in Rhode Island, including not-for-profit nursing homes, assisted living facilities, senior housing providers, and PACE as well as adult day health centers, employing over 1,000 professionals and caring for 3,000 elderly clients. The mission of the association is to expand the world of possibilities for aging.
About RI Health Care Association
The Rhode Island Health Care Association is a state affiliate of the American Health Care Association. RIHCA represents the interests of the skilled nursing care community, including their residents, to government, business leaders, and the general public. Our 66 member homes employ more than 10,000 workers caring for more than 7,500 residents, 24 hours a day, seven days a week. RIHCA also serves as a force for change within the long-term care field, providing information, education, and administrative tools that enhance quality at every level.