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Is Massachusetts' 'Robin Hood' Nursing Home Fee Unfair?

  • January 30th, 2003

Massachusetts has enacted a 'Robin Hood' scheme to help financially strapped nursing homes: a user fee will be assessed on private-pay patients, and the revenue will be used to supplement Medicaid reimbursement. The fee unfairly penalizes those who pay for their own nursing home care, say critics, according to an article in the Boston Globe.

The nursing home industry requested the tax. The industry has been losing money partly because the state Medicaid reimbursement rate for nursing home care is about $20 a day less than the actual cost of such care. Medicaid covers nearly three-quarters of the state''s nursing home patients. The new fee is a strategy to increase Medicaid money flowing to nursing homes without the state paying a cent.

Here's how it works: The 8,000 nursing home patients who pay for their own care will be asked to pay the fee, which amounts to about $9.60 per day or $3,504 a year. This will raise an estimated $145 million a year, $130 million of which the state will use to increase Medicaid reimbursements to nursing homes.

But opponents of the fee contend it unfairly penalizes people who have purchased long-term care insurance or who are using savings to pay for nursing home care.

''''They are taxing the people who have scrimped and saved,'''' said Maryellen Anastasia of Plymouth, who has power of attorney for a nursing home resident.

Steve Graham of Woburn, who is paying for his wife''s nursing home stay, warns that the new fee will mean that patients will deplete their assets faster, forcing them to go on Medicaid earlier. ''''It''s absolutely ridiculous,'''' he said.

State officials counter that private-pay patients who live in nursing homes that care for Medicaid beneficiaries will benefit from better-staffed facilities.

The federal government has not yet approved the fee, although approval is expected and many Massachusetts nursing homes already have begun collecting it. Nearly 20 other states have a similar fee.

For the full Boston Globe article, click here. (Article may be only temporarily available.)

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Felinton Elder Law & Estate Planning Centers
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Needham Mitnick & Pollack, PLC
Falls Church, VA


Last Modified: 01/30/2003

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