Springfield – Illinois lawmakers are voicing opposition to a backroom deal that may put the state’s new rate-setting formula for Medicaid reimbursement to nursing homes on hold. Senator Dan Rutherford (R-Pontiac) and Representative Eileen Lyons (R-LaGrange) spoke out against the plan to derail fair funding for nursing homes in Illinois.
Rutherford was the chief negotiator of the new Minimum Data Set (MDS) rate method, which is based upon the actual medical need of the resident not on the geographic location of the nursing home itself. The law, directed to take effect July 1, 2003, addresses the results of two years of effort in a series of public hearings on nursing home closings and the large disparities in reimbursement rates.
“While there is significant work to be done, the MDS is a big step toward fairly funding nursing homes in our state. This new ‘Rational Reimbursement’ for long term care will ensure that the money will go to the nursing home residents most in need of medical care,” said Rutherford. “Simply put, the greater the medical need of the resident, the more Medicaid money the home will receive to help care for that person.”
Lyons commented, “Delaying implementation of the MDS only helps compound a growing problem. Following the timeline for the present law is a must.”
Rutherford became concerned about potential delays in implementing the new law after one of the state’s nursing home associations, the Illinois Council on Long Term Care (ICLTC), attempted to delay the rule-making process for the new law.
“The Council is trying to derail this process. Their motives are not in the best interest of the state’s nursing home residents, whether private pay or Medicaid recipients,” Rutherford indicated.
Rutherford also revealed that ICLTC is attempting to contractually team up with the Service Employees International Union (SEIU) to lobby for a delay in the implementation of the MDS. In exchange for SEIU’s support on this matter, ICLTC will offer a certain percentage of their nursing homes to be unionized.
According to Rutherford, the legislative effort to delay implementation of the MDS for one year is unnecessary because of a two-year hold harmless provision in the original law. This would ensure that no nursing home in Illinois receives less funding over the next two years.
“I understand there is an effort to increase the provider tax in nursing homes. That battle will play itself out on its own, but to delay the MDS now would only help exacerbate the problem if more money goes to nursing homes. The rich will get richer and the poor will get poorer,” said Rutherford. “While I have no problem with a union negotiating to unionize a nursing home, I do have a problem with political pressure by the Council that hurts senior citizens with the greatest medical need.”
An amendment to House Bill 701 is currently pending in the Senate and is the vehicle for delaying implementation of the MDS.
