7 Providers File Suit Against Illinois Department of Healthcare and Family Services

By a News Reporter-Staff News Editor at Insurance Business Weekly -- - sb2 Inc., a leading law firm in Medicare/Medicaid Eligibility and Reimbursement cases, announced 7 different lawsuits filed for approximately 162 providers representing hundreds of nursing home residents in multiple long-term care facilities located in Illinois. The related lawsuits have all been filed against the Illinois Department of Healthcare and Family Services. All cases stem from the current Medicaid application backlog and its impact on residents at each facility.

The complaints allege that the backlog is due in part to a failure by the state agency to use an electronic asset verification program (AVP) to determine eligibility for Medicaid in a timely fashion. "Congress passed a law in 2008 that clearly defines that states must implement an AVP system," explained Chad Bogar, Managing Partner and CEO for sb2 Inc. "Not only did the state in this case not try to obtain resident information through AVP, they also did not try to access this information through secondary sources. The result is a serious backlog that is impacting facilities' ability to care for their residents."

To date, there is currently a backlog of approximately 7000 cases pending Medicaid review. In Illinois, Medicaid covers seniors that do not have the ability to pay for long-term nursing home care, when they do not have the personal assets to cover care expenses. "Federal law requires that states process applications within 45 days," said Bogar. "Right now, we're seeing applications being delayed a year or longer in some cases. This means that residents are at risk of losing their ability to stay at a facility and receive care. It's also putting an unnecessary financial burden on the facilities that are trying to maintain a high quality of care for these residents."

"This is a clear issue that needs quick resolution," continued Bogar. "The state of Illinois needs to start using AVP and start shrinking this backlog of applications, as these elderly residents simply cannot afford to wait any longer."

Keywords for this news article include: Medicaid, Legal Issues, Business News, Health Policy, Risk and Prevention.

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