Press Releases
Opinion Editorial Submitted to the Rocky Mountain News 03/06
Unpaid Medicaid Debt Hammers Colorado’s Healthcare System
By Bob Jones
Life Care Centers of America
Health care providers throughout Colorado are being buffeted by woefully slow payments by the state Medicaid agency that have resulted in a debt of more than $12 million. Legislation that would give patients and providers essential new tools to compel timely payments is under consideration at the Capitol – and without its passage, the status quo poses real risks to the health care of our most frail and vulnerable citizens.
The Medicaid program is the safety net that supports our elderly – including many of our veterans in nursing homes – and the poor. Under the law, Medicaid has up to 90 days to determine applicants’ eligibility for the government-funded health care program. That’s three months to determine whether, for example, a frail and elderly Coloradan can remain in a nursing home. The agency is then required to pay the nursing home for the essential services that eligible patients need and deserve.
That’s what the agency is supposed to do. But, in many cases, it just isn’t doing it.
Why? State law provides no penalty for the agency ringing up such a large and damaging debt. And the providers who are owed the money have very little leverage to compel the agency to pay its bills.
The absence of sanctions for the agency’s failure to process patient paperwork on time provides an incentive for missing deadlines. Missed deadlines result in late payments to providers. The resulting debt is staggering, and rising. The Colorado Health Care Association reports that Colorado nursing homes alone are owed upwards of $12 million. Hospitals, rural health clinics and others that care for the elderly and the poor face these financial challenges as well.
You don’t have to be an accountant to comprehend the damage that this sizeable unpaid debt does to health care providers, which, like most successful small businesses, operate on relatively narrow cash margins. They cannot afford to carry – or in some cases, write off – debts that they are owed.
An examination of the debt owed to nursing homes in the Denver area illustrates the breadth and depth of this serious problem. One Arapahoe County nursing home is owed more than $260,000, while a home in Denver is owed nearly $102,000. These large sums, sadly, are not unusual.
It’s not just private sector facilities that are being squeezed by Medicaid’s failure to pay its bills on time. This situation is threatening the care of our veterans who are in state veterans’ nursing homes. Four of the five homes report that they are owed collectively more than $500,000 in back payments for services such as feeding, medical care and other life-sustaining aid. These facilities, which face deep challenges every day in caring for the men and women who wore our nation’s uniform, aren’t flush with funds. That half-million dollars should be working to make life better for those who made life better for us. Instead, those dollars are sitting in a government bank account waiting for paperwork to be processed by Medicaid.
In each of these cases, the damage isn’t limited to the facility itself. Whether it’s a hospital, a nursing home or a clinic, each provider has local vendors for such staples as food, linens, medical supplies and much more. Each of those vendors, which provide family-sustaining jobs in the local community, depends on being paid in full and on time. The agency’s slow payment process hurts these companies, and, by extension the local economy.
The significant and widespread consequences of the agency’s slow payments to providers underscores why it is so vital for our Legislature to act. Sponsored by Rep. Al White and Rep. Lois Tochtrop – two of the state’s leading advocates for quality health care – House Bill 1186 would empower recipients, their families and providers to address the problem of extensive and unnecessary delays in processing Medicaid eligibility.
Elderly and poor Coloradans, and their families, deserve respect and fairness. They deserve a systemic solution to solve this lingering problem permanently. Asking the agency to do its job, and pay its bills on time, isn't much to ask. But that's what the Legislature can and must demand this session. Our healthcare system, and the well-being of tens of thousands of frail and vulnerable men, women and children, are counting on action.
Opinion Editorial Submitted to the Steamboat Springs Pilot 03/06
Unpaid Medicaid Debt Hammers Colorado’s Healthcare System
Rep. Al White Leads The Charge to Protect Vulnerable Coloradans
By Arlene Miles, President and CEO
Colorado Health Care Association
Protecting the health care of Colorado’s most frail and vulnerable citizens, and preserving quality jobs throughout our state is the aim of critically important legislation being carried by state Rep. Al White this session. Enacting this all-important bill will help give patients and health care providers real leverage to compel Medicaid to pay more than $10 million it owes to nursing homes, hospitals, rural health clinics and other facilities.
The growing problem that Rep. White and other leaders in the Legislature are working to solve is as simple as it is serious. The Medicaid program is the safety net that supports our elderly – including many of our veterans in nursing homes – and the poor. Under the law, Medicaid has up to 90 days to determine applicants’ eligibility for the government-funded health care program. That’s three months to determine whether, for example, a frail and elderly Coloradan can remain in a nursing home. The agency is then required to pay the nursing home for the essential services that eligible patients need and deserve.
Yet while the law is clear about the timetable that the Medicaid agency is supposed to follow, there are no penalties in the law to compel it to meet that schedule. So, with no incentives, and little leverage for the providers who are owed funds to compel timely payments, it’s not surprising that payments very often are months late.
The resulting debt is staggering, and rising. Data compiled by the Colorado Health Care Association show that Colorado nursing homes alone are owed upwards of $12 million. Hospitals, rural health clinics and others that care for the elderly and the poor face these financial challenges as well.
You don’t have to be an accountant to comprehend the damage that this sizeable unpaid debt does to health care providers, which, like most successful small businesses, operate on relatively narrow cash margins. They cannot afford to carry – or in some cases, write off – debts that they are owed.
This sad situation not only is hurting private-sector facilities throughout Colorado. It’s also threatening the care of our veterans who are in state veterans’ nursing homes. Four of the five homes report that they are owed collectively more than $500,000 in back payments for services such as feeding, medical care and other life-sustaining aid. These facilities, which face deep challenges every day in caring for the men and women who wore our nation’s uniform, aren’t flush with funds. That half-million dollars should be working to make life better for those who made life better for us. Instead, those dollars are sitting in a government bank account waiting for paperwork to be processed by Medicaid.
In each of these cases, the damage isn’t limited to the facility itself. Whether it’s a hospital, a nursing home or a clinic, each provider has local vendors for such staples as food, linens, medical supplies and much more. Each of those vendors, which provide family-sustaining jobs in the local community in each affected county throughout the state, depends on being paid in full and on time. The agency’s slow payment process hurts these companies, and, by extension the local economy.
Fortunately, thanks to Rep. White – who continues to be one of the state’s leading champions of quality health care – there is a common-sense fix under consideration at the State Capitol. House Bill 1186 would empower recipients, their families and providers to address the problem of extensive and unnecessary delays in processing Medicaid eligibility.
Elderly and poor Coloradans, and their families, deserve respect and fairness, and that’s exactly what Rep. White’s bill would give them. They deserve a systemic solution to solve this lingering problem permanently. Asking the government to do its job, and pay its bills on time, isn’t much to ask. But that’s what the Legislature can and must demand this session. Our healthcare system, and the well-being of tens of thousands of frail and vulnerable men, women and children, are counting on action.