Thank you Judge Elaine Bucklo, of the Northern District of Illinois!! Judge Bucklo’s opinion filed on June 7, 2017 (Bucklo’s Medicaid Opinion) is great news for nursing home residents and nursing home facilities dependant on payments from Medicaid. During the past year, a whopping seven civil rights lawsuits have been filed against the director of the Illinois Department of Healthcare and Family Services (DFS), alleging a failure to provide medical services to patients in a reasonably timely manner.
Illinois is perhaps the worst state in the entire country, when it comes to processing and paying Medicaid claims for nursing home care. Medicaid applications commonly take over one year to process, and patients are routinely put through the ringer with unreasonable requests for supporting documentation. Seriously, who can remember why they withdrew $200 in cash from their ATM four years ago? Medicaid applications are routinely delayed and denied for patient’s failure to satisfy such unreasonable requests made by DFS. The extreme delays in processing Medicaid applications, along with haphazard approval standards put patients in untenable situations, and create burdensome financial pressures on nursing homes. These wrongful practices by DFS, in large part, are responsible for the shortage of nursing home beds for patients throughout Illinois.
Civil rights lawsuits can be a wonderful technique for attorneys to help protect citizens rights against government abuses. The idea is similar to the police misconduct/excessive force lawsuits that are all too commonly filed against the Chicago Police Department. One of the advantages of filing a civil rights case is that the attorneys fees are not paid by the client, but are paid by the government if the case is won. I believe these civil rights Medicaid cases have been long overdue. Many believe that Illinois DFS has intentionally made obtaining Medicaid benefits for nursing home care extremely difficult to obtain, because of the state’s dire budget crisis. Similar cases in other states (Maine, Washington D.C., etc.) have been filed with great success, requiring state Medicaid agencies to act more quickly in approving Medicaid applications and pay nursing homes on time. Federal law requires applications be approved within 45-90 days of submission. DFS will have to hire more staff to meet those deadlines. How they will pay for that staff is another matter, and is not Judge Bucklo’s problem.
If you or a loved one has been improperly denied Medicaid nursing home benefits for no good reason, or if your fully completed Medicaid application has received no action from DFS, in excess of 90 days, please call my office (ph. 847-410-3191) and I will try to help you find a civil rights attorney who can file your case.