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8:03 p.m. • 5-19-13

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Comments :: Medicaid bureaucracy pinching some NC group homes

9 Comments


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A lot of these people used to live at Dix

HOw many people are in the home? Most long care places do not have NEAR enough people working to take care of the number of patients. It is entirely possible this one person is handling fewer people than the nursing homes handle.

First of all, more than 5 or so people are in the house. They rotate in and out. It is not a long-term care facility (nursing home). These are developmentally challenged persons who probably work for prisoner wages making light bulbs.

"The (not) funny thing is some of these group homes are scamming the patients they are supposed to care for. Owner bought a house next to mine. One lady lives there around the clock. Every morning a dilapidated van loads up everyone and they go off to somewhere. Then come back. One woman cannot care for that many people."

HOw many people are in the home? Most long care places do not have NEAR enough people working to take care of the number of patients. It is entirely possible this one person is handling fewer people than the nursing homes handle.

"Now neither group is covered. NC lawmakers could have covered both groups, but chose to cover neither."

It is not the lawmakers that cover ANYONE. It is the taxpayer. The money does not exist. this is what happens when people are dependent on GOVERNMENT for their well-being. I certainly hope this State is not dumb enough to expand Medicaid. It already can not pay for the current program. Now that amnesty is about to happen for the illegals, this program will have many new people on board.

The (not) funny thing is some of these group homes are scamming the patients they are supposed to care for. Owner bought a house next to mine. One lady lives there around the clock. Every morning a dilapidated van loads up everyone and they go off to somewhere. Then come back. One woman cannot care for that many people. When do I see the owner? When she pulls up to the mailbox every now and then in her Lexus SUV. But this is an improvement. It used to be there with no vehicle there around the clock. The old van came by and picked them up...now it stays there. Bilking the medicaid system to live in luxury. And this in not the only time I have seen this. I know you have too. Share your stories. For every good home there is probably 3 bad! Sad, sad, sad.

Medicaid changes are impacting therapists as well as group homes. For example, the form to request authorization to treat residents of Montgomery County is approximately 19 pages if you print the form. The current codes for Psychiatric Treatment are not even loaded into the system so it is impossible to request authorization for those services. In addition to this prohibitively lengthy and complicated form to request services, Medicaid has slashed their reimbursement rates. Providing mental health treatment to medicaid patients may be good for the soul but it might not keep your lights on.

The rules for what is paid by Medicaid changed January 1. Medicaid no longer pays for personal care help fir those in group homes. It never paid for such services for those still living in their own homes. Those living independently sue to be treated equally. Now neither group is covered. NC lawmakers could have covered both groups, but chose to cover neither.

the delays are due to the nursing homes beginning to submit their clains directly to that new mmis system that is supposed to be fully online in july.

so they take the group of medicaid providers that live paycheck to paycheck and have a huge voice and make them convert to the new system first. great insight. dma will write them all checks while the claims catch up. don't worry this will all be hushed up.

This is a perennial complaint! When are the clowns at DMA going to do some work, stop fighting among themselves, and get this system in? Even if it means you have to work an 8 hour day.

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