Federal court orders IL Medicaid program to process eligibility applications in LTC suit

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Illinois' Medicaid program must process a backlog of eligibility applications by mid-October, bringing relief to long-term care consumers and providers, a federal court ruled last week.

The case was brought by healthcare providers and residents against Felicia Norwood, director of Illinois' Department of Healthcare and Family Services, claiming the department has failed to process Medicaid applications and issue the program's benefits in a timely manner.

In an order published Friday, Judge Elaine E. Bucklo with the United States District Court for the Northern District of Illinois ruled that the group showed enough evidence of the harm — ever-growing nursing home bills for the residents, and an inability for providers to continue caring for residents — the application delay has caused them.

“It is fair to infer from these statements that, without preliminary relief, patient plaintiffs may soon face discontinuation of their long-term care services,” Bucklo wrote. “Plaintiffs have the better argument. The public has an interest in ensuring that Medicaid eligible individuals promptly receive necessary medical services. This, after all, is why Medicaid exists.”

Bucklo ordered DHFS to determine eligibility for beneficiaries whose applications have been pending for more than 90 days and notify them of their status by Oct. 16, 2017. She also ordered Norwood to ensure the department processes the applications with “reasonable promptness” and “timely payment provisions.”