I have seen the future of long-term care.
By all indications, it is going to be very good. At least, for law firms serving this sector.
For context, please allow me to direct your attention to an external development rife with internal implications.
On Thursday, a lobbying group representing home health providers sued the Centers for Medicare & Medicaid Services. The allegation? Payment parsimony.
Specifically, the National Association for Home Care and Hospice is attempting to stop the government from imposing Medicare payment cuts. If enacted, the reductions could trim reimbursements by more than $18 billion in the coming decade.
NAHC is arguing that the calculations used by CMS are flawed and unfair. Moreover, the inevitable payment reductions will fuel staffing shortages and reduce care access. Ring a bell?
The next paragraph might also soon induce a feeling of deja vu:
“We have done everything possible to get [CMS] to understand the disastrous consequences of its actions,” said William A. Dombi, president of NAHC, in a statement. “We have presented hard facts, deep legal analyses and extensive data to [CMS] that demonstrate the errors in its policies, to no avail.”
Now, given that CMS has not always offered skilled care payments operators would consider adequate, and that the agency has promised to impose first-ever staffing requirements, do you think that we might see a similar response from the long-term care sector?
I’m no Nostradamus, but it sure seems possible. Or to be more precise, likely. In fact, the American Health Care Association recently threatened to do exactly that. Especially if the looming staffing requirement is not to AHCA’s liking. Which it is all but guaranteed not to be.
I suppose it’s anyone’s guess how a lawsuit to change the way CMS calculates rates and working conditions might play out.
On the one hand, it would seem to be a legitimate tool for holding cheapskates more accountable. On the other, participation in the Medicare and Medicaid programs is, ahem, voluntary.
What we know for sure is that new lawsuits will certainly create a billing bonanza for participating law firms. And guess who’s on the hook for those payments?
If or when more legal action follows, you can be sure the trial lawyers will be richly rewarded. As for long-term care providers? I’ll have to get back to you on that.
John O’Connor is editorial director for McKnight’s.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.
