Our state has already had its hand slapped over delayed Medicaid payments and history has just repeated itself. Earlier this month, a judge ruled that Illinois was responsible for delinquent Medicaid application approvals and is allowing seniors who faced delays to sue the state. Seniors who applied for Medicaid after February 1, 2015, who were eligible for the program according to state requirements, and whose care was denied or hindered as a result of a delayed final eligibility determination can pursue action. According to the Centers for Medicare & Medicaid Services (CMS), states have 45 days to process and respond to a Medicaid application. Illinois has 90 days to process Medicaid applications that involve a disability. Many seniors have reported facing delays far greater than 45 days, even after submitting all necessary paperwork.
As a result of delayed approvals, nursing homes have had to discharge current residents and turn away potential residents. Seniors have also reported not being able to receive the care they need, missing out on crucial healthcare, drugs, and services.
Illinois: A Repeat Medicaid Offender
Illinois has a long history of being unable to keep up with Medicaid applications and reimbursements. In the 90s, a judge ruled that Illinois had to pay its Medicaid obligations, regardless of the budget crisis the state managed to get themselves in. Back then, the state was consistently short reimbursing health care providers for care for low income Illinois residents and senior citizens on Medicaid. Inadequate or delayed reimbursements to health care providers can impact their ability to offer care and services to others.
Then, last July, a federal judge determined that Illinois was slacking on the court order from the 90s and ruled that Comptroller Susan Mendoza was to come up with a mutually agreed upon payment plan with plaintiffs.
Discharged by a Nursing Home or Putting Off Appointments?
If your loved one was eligible for Medicaid and was discharged from their nursing home while waiting for a final determination, you may have a case. If your loved one put off seeing a doctor or filling a critical prescription and has suffered as a result, you may have a case. An experienced elder law attorney can help you. Since 1992, the attorneys of Chicago’s Levin & Perconti have recovered hundreds of millions in verdicts and settlements for families whose elderly loved ones have been the victims of oversight, abuse, and neglect at the hands of the state or reckless nursing home operators. Consultations with our attorneys are free. Please contact us now to find out how we can help you.