A group of Illinois nursing homes has asked a federal judge to order the Illinois state government to pay them for services rendered to
patients receiving assistance under Medicaid, saying the state has failed to
live up to its obligations under federal law to promptly process patient Medicaid
applications for a number of their nursing home residents or pay their claims.
On Nov. 15, the nursing homes, located in the downstate Illinois
communities of Danville, El Paso, Pana, Mendota, Hoopeston, Beardstown, Normal,
Peru, Paxton, Jacksonville and others, filed suit in Chicago federal court against the
Illinois Department of Healthcare and Family Services, ostensibly on behalf of
a group of patients whose Medicaid-eligible care has not been reimbursed in the
past year or more by the state.
All of the nursing home plaintiffs are associated with
Bloomington-based Heritage Operations Group LLC, which operates numerous
nursing homes throughout Illinois.
The lawsuit names Felicia Norwood, director of the IDHFS, as
a defendant, in her official capacity.
According to the lawsuit, each of the patients identified in
the lawsuit have racked up large bills with the nursing homes at which they
reside, and the state has not properly processed and paid their claims for
reimbursement, dating back to 2014 in some cases.
The lawsuit accuses the IDHFS of failing to establish a
program to efficiently evaluate the patients’ eligibility for Medicaid and pay
their claims, effectively placing the burden on the patients to establish
eligibility for those payments, which the lawsuit said violates federal law.
“In light of the Defendant’s failure to comply with federal
and state Medicaid laws, the Plaintiffs have been unable to pay for their room,
board, care and services at Heritage facilities during their period of Medicaid
ineligibility,” the lawsuit said. “Such inaction by the Defendant places the
Plaintiffs at risk of being discharged from Heritage facilities, and
jeopardizes their health, safety, and well-being.”
The lawsuit comes as Illinois continues to suffer from a
backlog of unpaid bills.
The complaint does not reference the state government’s
ongoing financial problems or fiscal crisis.
However, last year, a federal judge ordered the state to
make Medicaid payments to health care providers and hospitals, despite the lack
of a state budget at that time.
The Heritage nursing homes lawsuit doesn’t specify how much
the nursing homes believe they are owed for care provided to the patient
referenced in the lawsuit, or the other potential plaintiffs under the putative
The complaint asked the court to order the state to abide by
the requirements of the Medicaid law and other applicable federal laws, and to
order the state to “arrange for medical assistance and nursing facility
services to the Plaintiffs and Class,” as well as to pay attorney fees and
potential compensatory and punitive damages.
The nursing homes are represented in the action by attorney
Katie Z. Van Lake, of the firm of SB2 Inc., of Harrisburg, Pa.