Lubarsky: Medicaid shortfall expected to widen in 2009

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Skilled nursing facilities face a projected Medicaid shortfall in 2009 of $15.64 a day, Joseph Lubarsky, a partner with accounting firm Eljay LLC, said Monday.

That compares with a shortfall of $15.52 a day in 2007, said Lubarsky, who released the preliminary Medicaid reimbursement study findings at the American Health Care Association's annual conference in Chicago Monday. While the under-funding is not increasing sharply for 2009, it is expected to expand wider in 2010 as state budget shortfalls affect Medicaid shortfalls, he said.

While states received $87 billion in increased federal medical assistant percentage (FMAP) funding as a result of the stimulus package this year, states haven't use it to increase Medicaid rates, Lubarsky said. Instead, they have used it to balance their budgets. A total of 48 states face budget shortfalls.

Meanwhile, Medicaid expenditures for home- and community-based services continue to grow. They soared by nearly 142% from 2000 to 2008. Medicaid expenditures for nursing facilities only increased by 24.5% during that time.

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