Lawmakers and advocates question spending boost for nursing homes

By David Jacobs | The Center Square

A change to how Louisiana’s health department pays nursing homes is expected to cost the state an extra $5 million-plus per year.

State officials say the boost is meant to benefit nursing home residents by encouraging facilities to establish private rooms, though some advocates and lawmakers say there are better uses for the extra dollars.

The Louisiana Legislature’s Joint Medicaid Oversight Committee met Tuesday. Rep. Tony Bacala, a Prairieville Republican, said Louisiana has a higher proportion than other states of residents in nursing homes, as compared to those receiving home health. Allowing people to receive services in their homes is cheaper, he said.

Groups representing older and disabled residents said many of the people they advocate for would prefer to receive services at home and questioned the spending increase during a time of economic uncertainty. Bacala has in the past said the nursing home industry gets special treatment because of their political influence.

Andrew Perilloux with the Louisiana Department of Health said nursing home residents prefer private rooms, which are associated with better health outcomes. They also make it easier to isolate someone who has an infectious disease such as COVID-19, though that’s not the reason LDH made the change, he said.

Rep. Larry Bagley, R-Stonewall, said he preferred nursing homes because with home health it’s impossible for regulators to know if the services taxpayers are paying for are being performed. Nursing homes, by contrast, have staff on duty 24 hours a day to care for residents.

Despite the name, the oversight committee that met Tuesday has no regulatory authority over the Medicaid program. The heads of the committees that do have that authority declined to take up the issue, so the new rule goes into effect Dec. 20.

In other discussions Tuesday, Tara LeBlanc, interim head of the state’s Medicaid program, said they were launching three pilot programs that involve working with credit bureaus to begin using credit applications as a possible tool to uncover Medicaid fraud. While people might be tempted to understate their income to qualify for Medicaid, which is taxpayer-funded health insurance for low-income residents, they are less likely to do so if they’re applying for credit, LeBlanc suggested.

She said LDH also is meeting with the Department of Revenue to find ways to expand the use of state tax data to verify eligibility.

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