Some Medicaid providers borrow or go into debt amid ‘unwinding’ payment disruptions – Boston Herald

Katheryn Houghton | KFF Health News (TNS)

Jason George began noticing in September that Medicaid payments had stalled for some of his assisted living facility residents, people who need help with daily living.

Guardian Group Montana, which owns three small facilities in rural Montana, relies on the government health insurance to cover its care of low-income residents. George, who manages the facilities, said residents’ Medicaid delays have lasted from a few weeks to more than six months and that at one point the total amounted to roughly $150,000.

George said the company didn’t have enough money to pay its employees. When he called state health and public assistance officials for help, he said, they told him they were swamped processing a high load of Medicaid cases, and that his residents would have to wait their turn.

“I’ve mentioned to some of them, ‘Well what do we do if we’re not being paid for four or five months? Do we have to evict the resident?’” he asked.

Instead, the company took out bank loans at 8% interest, George said.

Montana officials finished their initial checks of who qualifies for Medicaid in January, less than a year after the federal government lifted a freeze on disenrollments during the height of the covid-19 pandemic. More than 127,200 people in Montana lost Medicaid with tens of thousands of cases still processing, according to the latest state data, from mid-February.

Providers who take Medicaid have said their state payments have been disrupted, leaving them financially struggling amid the unwinding. They’re providing care without pay, and sometimes going into debt. It’s affecting small long-term care facilities, substance use disorder clinics, and federally funded health centers that rely on Medicaid to offer treatment based on need, not what people can pay.

State health officials have defended their Medicaid redetermination process and said they have worked to address public assistance backlogs.

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