A legal fight related to Medicaid providers and wages is dropped

Jul 11, 2023 | State Mandates & Medicaid

A legal fight related to Medicaid providers and wages is dropped

Industry groups and the Florida Agency for Health Care Administration have agreed to end a legal fight about part of last year’s state budget that could have opened Medicaid providers to litigation if they didn’t pay a $15 minimum wage to “direct care” workers.

Attorneys for the Florida Ambulance Association, Florida Assisted Living Association, two other plaintiffs and AHCA last week filed a joint motion in Leon County circuit court to dismiss the case. The motion said a new state budget that took effect July 1 did not include the disputed issue.

Last year’s budget included fine print that directed money to the agency to adjust reimbursement rates so Medicaid providers would pay at least $15 an hour to direct-care employees. Also, the budget said that as of Jan. 1, employees could file civil lawsuits against providers that did not pay $15 an hour, including possibly class-action lawsuits.


Health News Florida


July 11, 2023


News Service of Florida. “A Legal Fight Related to Medicaid Providers and Wages Is Dropped.Health News Florida, 11 July 2023, health.wusf.usf.edu/health-news-florida/2023-07-11/a-legal-fight-related-to-medicaid-providers-and-wages-is-dropped.

More News in this PBJ Topic

3 Nursing Home Legal Issues to Watch in 2022 and Beyond

As a flurry of regulations and mandates descend upon the nursing home sector, such changes could create legal obstacles, and suggest yet another difficult and onerous year for providers.

Staffing mandates, the aftermath of the end of the public health emergency (PHE), Covid liability and the PREP Act, all create “existential threats” for skilled nursing operators, at a time when so many are still attempting to recover from the last two and a half years.

read more

Medicaid nursing facility payment approaches

CMS encourages states to
assess their approach to payments to long-term care providers and utilize flexibilities provided
by section 1902(a)(30)(A) of the Social Security Act (the Act) in establishing Medicaid base and
supplemental payments, as appropriate, to provide adequate, performance-driven nursing facility

read more

Why States’ Success in Tying Medicaid to Staffing Could Propel CMS Policy

While establishing stronger staffing standards for nursing homes continues to be a top priority in the minds of federal leaders, few in the industry see it as a viable or sustainable path forward.

Unable to sustain unfunded mandates, senior living advocate and policy expert Brian Perry thinks tying increased reimbursement on a state-by-state level is a great “first step” but fixing the problem at the macro level is also needed.

read more

Nursing homes sue over minimum staffing ratios, mandatory spending levels

Nonprofit New York nursing homes are taking action against the state in a push to overturn “illegal and unconstitutional” policies that establish a minimum staffing requirement and spending mandates for providers.

LeadingAge New York, leading a group of 80 nonprofit and public nursing homes, on Monday filed a lawsuit against the state over the two statutes being enacted during the COVID-19 public health emergency.

read more

Nursing Homes Pay ‘Exorbitant’ Agency Costs to Comply With Staffing Minimums

State staffing minimum laws are colliding with spiking agency costs, with some facilities forced to continue or increase the use of expensive temporary staff to meet state requirements.

The dissonance is especially felt in states like New York, which has the largest Medicaid reimbursement shortfall in the nation, according to Stephen Hanse, president and CEO of the New York State Health Facilities Association (NYSHFA).

read more

Next Quarterly Payroll-Based Journal Data Submission Due

We remind nursing home members that Payroll-Based Journal (PBJ) data submissions covering Jan. 1st through March 31st must be finalized with the Centers for Medicare and Medicaid Services (CMS) by May 15th. PBJ submissions have been the basis for calculating the staffing domain of the Five-Star Quality Rating System for several years, and they are now being used to compute staff turnover and weekend staffing rates currently being displayed on Nursing Home Compare. As of July of this year, CMS expects to incorporate these measures into the Five-Star calculation.

read more