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Insurance payment crisis: Nursing homes now impacted

CINCINNATI (Jeff Hirsh) -- The Butler County Care Facility is a county-owned nursing home with around 100 beds and 135 employees.

Along with many independent home health care providers and health care agencies, the Butler County home was supposed to get insurance payments through a new program called 'My Care Ohio.'  They they're still waiting on the first payment.  There has been nothing since June 1, when insurance companies took over making payments instead of the state.
   
So the Butler County Commissioners advanced the care facility $250,000 to keep the home going until insurance payments ultimately come in; however, most nursing homes are private and don't have a county backup:

Chuck Demidovich of the Butler County Care Facility said, "I don't know how the other homes are going to make it.  I think this is going to be the hardest thing for them and I honestly believe it will bankrupt some.  My personal opinion is a third of the homes will go under."

The My Care Ohio program was supposed to make things more efficient, more streamlined and less bureaucratic.  But at the Butler County Care Facility they've had to double the size of their accounting staff, from one to two, to handle all the increased paperwork in a program that was supposed to reduce paperwork.

The nursing homes used to bill the state directly.  Now they have to file with a billing firm, which then bills insurance.  Employees realize they're lucky they work where they do and not at other homes which might be in jeopardy for not getting their insurance payments.

Billie Vaughn, an employee at the Butler County Care Facility, said, "You get a situation like that where employees might quit and go somewhere else because they may not get paid.  But I don't think that's the case here.  We all feel pretty safe with it."

There's still no telling when the insurance payment fiasco will be over.  But those waiting for payments said the insurance companies certainly need to be more flexible in paying quickly.  Local 12 did the first story on the health payment mess Tuesday, July 22, with home health care nurse Tammy Taulbee, who had not been paid since June 1.  Taulbee told Local 12 she's been informed by Aetna insurance that she'll be getting more than $5,000 Tuesday.

A local legislator on the Medicaid oversight committee said he was, "Not happy about what's going on' with the insurance payment situation."  State senator Bill Coley of Liberty Township said legislators have been meeting with the state Medicaid director and representatives of the insurance companies, trying to get the problems resolved.  Coley said the issue will likely be discussed at a public hearing and he also wants to take a look at the investigative reports done this past week by Local 12 News.

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