Medicaid reimbursements cross hurdle in Senate

Senior service providers 'elated;' bill headed to House

State senators unanimously passed a bill Thursday that would increase funding for some nursing facilities.

Senate Bill 818 requires Missouri to increase the amount of money it pays skilled nursing facilities for care of patients who use Medicaid. Under Missouri's current formula, the state should reimburse SNFs $178 per patient per day. Instead, it only pays $154 per patient per day.

The state came to that rate based on a calculation from 2004.

The bill would require the state to incrementally increase the rate it reimburses facilities over the next three years (until 2021), when it catches up with the state formula.

At that point, the state should recalculate the reimbursement rate every July 1, the bill's sponsor, state Sen. Dan Brown, R-Rolla, said in a news release.

Because the bill has an emergency clause, it would go into effect immediately upon the governor's signature. That's several steps down the road.

John Kotovsky, CEO of Lutheran Senior Services, a major provider of senior services in Missouri and Illinois, praised the Senate for unanimously passing the bill.

"We are very pleased that the Missouri senators have recognized the responsibility the state has for our most vulnerable adults," Kotovsky said. "A 31-0 vote shows bipartisan support for this and the recognition that the state needs to make up the gap and take care of our vulnerable adults."

Lutheran Senior Services recently provided data that show, of the money the state reimburses skilled nursing facilities, $78.44 comes from federal funding, $30.76 from patient support (paid from patients' Social Security benefits), $21.53 from provider taxes (taxes paid by nursing homes on a per-bed basis), $15.26 from the Missouri General Revenue Fund and $7.82 from other sources.

Data showed Missouri, on average, pays about one-third of what surrounding states pay from their general funds toward Medicaid ($48.22).

Lutheran Senior Services and the Missouri Health Care Association understood they needed to work together to convince lawmakers of the need for additional Medicaid funding, Kotovsky said. MHCA is the largest long-term care association in the state, according to its website. Its members include skilled nursing facilities, intermediate care facilities, assisted living facilities, residential care facilities, adult day care, home health and hospice.

"We realized that we needed to speak with one voice," Kotovsky said.

He said nursing facilities are "elated" with the Senate's results.

However, there's still a lot of work to do to demonstrate the need for more funding to the House of Representatives, which now takes up the bill.

"Our residents have been sending letters to both senators and representatives," he said. "We know that it's still an uphill struggle, but representatives are taking notice."

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