Valley View Amongst those Suing DPHHS Over Medicaid

The Montana Health Care Association Executive Director Rose Hughes confirmed to The Glasgow Courier that Valley View Nursing Home is among the more than a dozen care facilities across the state suing the Montana Department of Public Health and Human Services for recent cuts in Medicaid reimbursements.

“The department violated the law when it adopted rules cutting reimbursement rates for Medicaid services in Montana,” stated Hughes in a release sent out June 11, adding, “The public is guaranteed a constitutional right to meaningfully participate in these kinds of decisions, but the department never gave us that chance. They repeatedly failed to provide basic information and their story about these cuts changed over and over again. These rate cuts hurt Medicaid recipients and care providers alike, and the stakes are too high for these kinds of decisions to be made without the public’s involvement.”

The cuts stemmed from the passage of Senate Bill 261 through the Montana Legislature’s 2017 budget proposal. The Department recommended a cut of 3.47 percent that it said was necessary to implement the budget cuts required by the law. Those cuts were later reduced to 2.99 percent in the rule changes final version after many objections, including from the Legislature’s Interim Committee on Children, Families, Health and Human Services, according to the MHCA press release.

Valley View Home Administrator Wes Thompson told the Courier, “I’m hopeful that the lawsuit will be enough to pressure State into re-evaluating its reimbursement program.” Valley County is no stranger to how Medicaid reimbursement has negatively affected the home’s long-term viability. Earlier this year, Valley County passed a hospital district to make up shortfalls in funding for the home’s operation. Much of that shortfall was due to the way Medicaid is reimbursed in the State of Montana.

The MHCA release stated, “The MHCA contends the department violated a number of provisions of the Montana Administrative Procedure Act. Among other violations, the department failed to show that the specific amounts cut from reimbursement rates were reasonably necessary. The department also did not give the plaintiffs and the public an opportunity to meaningfully participate in these significant rate setting decisions, as required by law. The plaintiffs (MHCA) also contend that reduced rates fail to meet mandatory levels specified in the law.”

A pivotal part of the argument against DPHHS is that the department has diverted bed tax funds that are statutorily intended to pay for nursing home care and diverted them to other programs. MHCA stated, “The legislature approved the new taxes to pay for compliance with new federal regulations and to reduce the cost shift to people who pay for their own care. The tax legislation even says that the new money is to be used only to increase rates above the then current rates. Now the department is trying to take some of that tax money intended to help nursing home patients for other purposes.”

The MHCA is a non-profit association founded in 1962, the association represents over 100 organizations that serve elderly and disabled Montanans.