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Why the NJ class action case is so important for protecting the rights of our clients and the elderly

Schutjer Bogar has filed a class action lawsuit against a leading Managed Care Organization (MCO). We are doing this because an MCO delaying payment to long-term care facilities is a situation we cannot tolerate as a nation. Here’s why:

  • Profit margins for long-term care providers are already extremely slim.
  • Delaying payment increases cost of operation for these facilities.
  • This increased cost can either force providers out of business or translate into less capacity to care for elderly residents.
  • Either way, this equals less services available for elderly residents that typically require 24-hr care.

When it comes to timely Medicaid payments, the current situation is clear:

  • The Federal Medicaid Act stipulates that MCOs are required to pay 90% of clean claims with 30 days of receipt and 99% of claims must be paid within 90 days.
  •  The MCO is not following proper payment rules, as our clients previously carried an aged Medicaid pending debt of approximately $30-$100 thousand dollars. Now, with the MCO taking over from the State of New Jersey, this figure has climbed to over 1 million dollars.

·      We believe that the MCO, through this action, is engaging in systemic, continuous adverse treatment of elderly long-term care residents. It is something that is spiraling into an epidemic, impacting the second-most vulnerable population group in the nation.


 


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