Arkansas Officials ‘Reinterpret’ Medicaid Rule to Control Costs for Private-Pay Nursing Home Patients

To prevent "skyrocket[ing]" costs for private-pay patients, the Arkansas Department of Human Services last week "reinterpreted" a reimbursement rule that had prohibited nursing home facilities from charging Medicaid beneficiaries more than private-pay residents, the Arkansas Democrat Gazette reports (Wickline, Arkansas-Democrat-Gazette, 6/13). The decision to review the law followed a series of changes that increased state Medicaid reimbursements to nursing homes. Under the law's original interpretation, the increase in Medicaid reimbursements reportedly led some homes to raise rates for private-pay patients by as much as $500 per patient per month (Kaiser Daily Health Policy Report, 6/8). Under the new reading of the rule, facilities will average the rates of private-pay and Medicare patients and prevent nursing homes from charging Medicaid patients more than the averaged rate. This policy will bring the non-Medicaid rate "much closer" to the new $89 per patient per day Medicaid rate and will reduce the incentive for homes to increase private-pay rates. Arkansas Medicaid Director Ray Hanley said that nursing homes must notify private-pay patients 30 days in advance of any rate increases resulting from the reinterpreted rule (Arkansas Democrat Gazette, 6/13).