Universal Nursing Home Settlement Discussion Resumes

State officials convened a meeting last week of legal counsels to discuss the Department of Health’s (DOH’s) proposal for a universal settlement of outstanding nursing home litigation and rate appeals. LeadingAge New York legal counsel and staff participated in the meeting. The prospects for reaching an agreement on the settlement remain guarded, but may become apparent in the next few weeks.

The April 30th meeting in Albany included officials from DOH, the Division of the Budget, the Governor’s office, the Office of the Attorney General and legal counsels representing nursing homes in various pending Medicaid rate litigation matters. DOH began by reviewing the broad terms of the proposed settlement, which would involve providing $475 million in additional payments to nursing homes over a five-year period. In exchange, nursing homes in the State would have to agree to drop nearly all pending lawsuits and rate appeals involving rates in effect prior to Jan. 1, 2012. DOH indicated that there are approximately 400 lawsuits and 7,900 rate appeals currently pending.  

Meeting participants were asked to evaluate the merits of the proposal and to develop options for addressing obstacles to an agreement being reached. Among the major concerns discussed during the meeting were the potential impact of the Medicaid global spending cap; the relationship of a facility’s settlement payments to the value of its litigation and appeals; the impact of previous transfers of facility ownership; and the fiscal impact on the State. DOH signaled a willingness to modify certain aspects of the State’s proposal.      

Further discussions among the legal counsels are expected this week, with a follow up discussion planned with the State soon. We expect that there will be resolution to the question of whether the settlement can move forward in the near future.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866