Maryland Shorted $49 Million in Medicaid Reimbursements

By MICHAEL WALSH, Capital News Service

WASHINGTON - Maryland was shortchanged $49.8 million for nursing home care by Medicaid in 2007, according to a report released by the American Health Care Association Wednesday.

Actual care in Maryland nursing homes costs on average $8.88 more than Medicaid pays per patient, per day, resulting in the shortfall in 2007.

By comparison, Illinois loses the most money in nursing home care, dropping $526.2 million in 2007, $30.21 per patient, per day.

Nationally, the nursing home shortages totaled $4.4 billion in 2007, down from the $4.6 billion states were forced to make up in 2005.

The gap between cost and reimbursement in Maryland has dropped 4 cents since 2005, according to the report.

The disparity has some politicians warning of Medicaid's end.

"If you don't pay for something, it will disappear," said Rep. Steve Kagen, D-Wis., at a press briefing.

David Hebert, vice president of government relations for AHCA, said Medicaid operates at an inherent shortfall, which could result in a lack of care providers.

"Long-term care operates with a 2.5-negative margin," Hebert said. "That could affect the ability to hire quality staff."

Georgia was the only state that profited from Medicaid reimbursement in 2007, making $1.41 per patient per day.

Maryland has taken steps to narrow the gap, passing a law designed to tax larger nursing homes and help the state cover the Medicaid money shortage.

The law requires nursing homes with more than 45 beds to pay 2 percent of their total net revenue each quarter in taxes.

Centers for Medicare and Medicaid Services must approve the law before it becomes active.

Mark Leeds, director of long-term care for the state health department, said that Maryland's proposed 2 percent tax is well under the federal maximum of 5.5 percent and will vary between care providers.

"The kinds of reimbursement changes are going to affect different providers differently," Leeds said. "On average, reimbursement will increase $4.36 per Medicaid patient per day."

Other states have passed laws for similar programs, Leeds said.

"It does require legislation, we can't do this type of assessment on every type of facility," he said.

If Medicaid isn't reformed, care for the elderly could take a step back to a previous generation, Kagen said.

"Medicaid must step up," Kagen said. "Or we will transform our country once again to where grandma and grandpa live at home with us."

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