Florida SNFs sue over Medicaid pay delay

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Ten Florida skilled nursing facilities have filed a class-action lawsuit against several insurance companies over their alleged failure to pay interest on overdue Medicaid payments. 

The suit names as defendants seven managed care companies, including affiliates of Humana, Molina Healthcare and United Healthcare.

The 21-page complaint, filed in August in the U.S. District Court for the Southern District of Florida, states that the plaintiffs “provide healthcare services to some of Florida's most vulnerable citizens” including the elderly and individuals with disabilities, many of whom require 24-hour complex medical care and suffer from cognitive impairments like Alzheimer's.

The lawsuit alleges that despite the SNFs providing proper claims for payment as outlined in their managed care contracts, the Medicaid managed care organizations “engaged in a pattern and practice of fabricating reasons to delay payments of claims to plaintiffs, and then paying an improper amount of interest, if any, on overdue payments.” 

Payments delivered after the deadline typically accrue interest at 12% per year.

The Florida Health Care Association, which has testified in the Florida Senate in support of the nursing home providers, has determined that many facilities carry more than $200,000 in outstanding claims, leading to a statewide shortfall of $135 million.

The SNFs argue the insurance companies' failure to pay interest on overdue claims has hindered their ability to provide certain services to Florida residents.

The lawsuit was brought against the managed care groups on behalf of the SNFs and “all other Medicaid providers similarly situated,” according to the complaint. The providers are seeking declaratory, monetary and other appropriate relief, court filings show.