Nursing homes seek overdue Medicaid managed care payments

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Several managed care organizations providing Medicaid coverage in Illinois are being accused in federal court of taking too long to get payments to skilled nursing facilities.

Aperion Care Inc., Bria Health Services LLC, Everest Care Group LLC and six others filed their complaint in U.S. District Court Dec. 12 against  several managed care organizations whose state contracts that require them to get beneficiaries needed treatment. Risk-based MCOs provide care for more than half of all Medicaid beneficiaries nationwide, according to the Henry J. Kaiser Family Foundation and Bloomberg.

The filing says Aetna Better Health Inc., Meridian Health Plan, Humana Inc., and Molina Healthcare of Illinois Inc. violated federal law because they didn't process and pay bills in a timely manner. In Aperion Care, Inc. v. Norwood, the plaintiffs argue the private companies should be held to the same standard as state Medicaid agencies, namely that patient bills should be at least 90% paid within 30 days of submission.

Bloomberg reported that a group of skilled nursing facilities in Florida brought a similar suit last August to collect overdue payments.