Universal Nursing Home Settlement Discussions Continuing

A group of legal counsels representing nursing homes in various pending Medicaid rate litigation matters has been actively discussing the terms of a proposed universal settlement of outstanding nursing home litigation and rate appeals. LeadingAge NY legal counsel has been involved in the entire process.  The prospects for reaching an agreement on the settlement remain somewhat cautiously optimistic, but are likely to become apparent in the next couple of weeks. 

Working with officials from the Department of Health (DOH), the Office of the Attorney General, the Division of the Budget and the Governor’s office, the goal of the exercise is to arrive at a consensus proposal and settlement amounts that would be advanced to facilities at some point this month. 

While the specifics of the settlement proposal remain under discussion and are subject to legal privilege, the overall settlement would provide up to $850 million in additional payments to nursing homes over a five-year period. Included in this figure is an estimated $350 million derived from continuing the 0.8 percent unreimbursed cash receipts assessment (which would be offset by a Medicaid increase). In exchange for these payments, 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 (i.e., the implementation of statewide pricing). DOH indicated that there are approximately 400 lawsuits and 7,900 rate appeals currently pending.   

Further discussions among the legal counsels and with the State are scheduled for this week. We expect that there will be resolution to the question of whether the settlement can move forward in the very near future, and will keep members posted on further developments. 

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