In an effort to determine whether individual Medicaid fees meet the legal standard of reasonability, advocates for needy seniors want the Iowa Department of Human Services (DHS) to consider itemization of how the state’s nursing homes spend their Medicaid reimbursements. “I’m not able to say today what our position is going to be,” Iowa Medicaid Director said at a recent meeting of the Legislature’s Administrative Rules Committee, according to an article in the Des Moines Register.
Currently Medicaid cost reports are submitted as lump sums without factoring out legal fees, association membership dues and other costs, including unrelated accounting and consulting fees. The DHS was first asked to consider itemization back in 2010 when the Iowa Department of Inspections and Appeals lobbied for the change.
The current proposal for the rule change, developed with input from trade associations, does not involve itemization of fees, which the Iowa Health Care Association says can be $18 million annually.
Fee itemization is the only way to guarantee transparency and accountability, Iowa Caregivers Association representative John Hale told the Register.
Since Medicaid can be billed for association dues and staff training, Lerner told the Des Moines Register, “This means Iowa taxpayers are paying for the cost of our state inspections and then, through Medicaid, they might also be paying for these homes to learn how to thwart the inspectors.”
The proposals to itemize the Medicaid cost reports will now go to the Iowa Council on Human Services for consideration.