Appeals Court Rejects Retroactive Payments For Medicaid Assisted-Living Services

Oct 2, 2016

A federal appeals court has rejected a lawsuit that sought retroactive payment for assisted-living services for people on Medicaid.

The 2013 complaint said Ohio was illegally omitting Medicaid coverage for people between the time they required assisted-living services and when a plan was authorized allowing the payments. The 6th U.S. Circuit Court of Appeals on Friday overturned a judge's decision that backed the retroactive payments. The appeals court said federal law permits Medicaid payments only for assisted-living services that are authorized by an approved service plan ahead of the payments being made. Janet Pecquet, an attorney representing assisted-living residents, said the ruling leaves people at risk of being forced out of such facilities for nonpayment.