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Montana health agency accused of defying order on Medicaid

July 24, 2018

HELENA, Mont. (AP) — The Montana Health Care Association said Tuesday that state health officials are defying a court order by once again cutting the reimbursement rates paid to nursing homes and assisted-living facilities that care for Medicaid patients.

But state officials have said they are complying, and the contradiction appears to stem from confusion about whether District Judge James Reynolds’ order blocking the rate cut expired on July 1.

The health care association and a group of nursing homes are suing to block the state Department of Public Health and Human Services’ cut to the daily rate at which nursing homes are reimbursed, which was made along with spending cuts across government agencies to close a state budget shortfall.

That 2.99 percent reduction can mean a loss of more than $100,000 a year for larger nursing homes, and the health care association and nursing homes say the cut was approved without a reasonable explanation or input. Nursing homes have had to turn away new Medicaid patients, as well as cut programs and staff, the plaintiffs said.

Reynolds temporarily blocked the rate cut on June 13. The judge wrote then that the temporary restraining order is effective until a new order is issued.

But he also wrote that the health department must pay the higher rate only for the remainder of the financial year, which ended June 30.

Health department spokesman Jon Ebelt said Tuesday that state law also requires a temporary restraining order to expire in 10 days if it was issued without notice to all parties.

Ebelt said last month that the department intended to pay the higher reimbursement rate only until June 30, and that the cost of complying with the order was between $200,000 and $300,000.

The case has been reassigned from Reynolds’ court to District Judge Mike McMahon’s, and a hearing is scheduled for Aug. 2.

On Friday, the Montana Health Care Association filed a new request with McMahon affirming that Reynolds’ temporary restraining order is still in effect, or to issue a new one.

The health department’s unilateral decision to reinstitute the rate cut without waiting for a judge’s order “is an affront to the authority of the court,” health care association attorney Lucas Hamilton wrote.

McMahon did not immediately rule on the request.

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