Medicaid Rate Litigation
NYSHFA has been advised that within the past week several of its member facilities have been solicited by a law firm to participate in litigation challenging the adequacy of nursing home Medicaid reimbursement rates set by the New York State Department of Health (“DOH”). This solicitation sets a deadline of this Friday, May 26th for a facility to join the litigation. Additionally, the law firm’s solicitation would require each facility to pay an upfront “suit fee” of $8,000 to cover initial proceedings at the trial court level, with additional fees of up to $6,000 for potential future appeals at the State Appellate Division and then the Court of Appeals. In addition, if the litigation culminates in either a settlement or rate increase, facilities would be expected to pay an additional contingency fee of 5 % of any settlement or rate increase in the first 12 months following the litigation that is attributable to the litigation.
Please be aware that NYSHFA, in tandem with other associations and following a meeting that included members of both the NYSHFA Board and the NYSHFA Multi-Owner Committee, is also considering the wisdom, feasibility and expense of initiating such litigation. It was determined that the first prudent approach to our comprehensive litigation strategy is to analyze the data and consult with a number of experts in order to develop a coherent strategy to achieve optimum results for all our members. We urge facilities, therefore, to carefully weigh their options, keeping in mind that the associations already have “critical mass” and, as a result, are able to access key experts and counsel, and spread the cost over the membership base to reduce the cost per facility for any litigation that is determined to be the appropriate strategy to pursue.
Separately, it is important to note that legislation has been introduced in both the Senate and Assembly (S.6914; Rivera/A.5905-A; Woerner) that would, among other things, require the DOH to update the non-capital component of the Medicaid rate, as well as the WEF, no later than 1/1/25 and no less than every 5 years thereafter using the most recent cost report data and updating nursing home Medicaid rates to reflect actual base year costs.
NYSHFA | NYSCAL CONTACTS:
Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11
