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As far as I know Medicaid was making income determination up to 2011 and the bill was paid every month on behalf of the family member resident of the facility. Last year the administration told me that payment is no longer due because private insurance is no longer the primary insurance, medicare is. But in December last year the billing resumed claiming that the non billing was due to a "computer glitch". I requested 3 times already that they provide me with a copy of the new determination for 2012 and 2013, to no avail, they keep on sending me 2011 now I have been threatened over the phone today PM that medicaid eligibility will be lost if the account is not dealt with I have till Monday 5:30. I Left two messages today. At this point what is the best course of action?
The 24-hour hotline handles consumer complaints and facility emergencies seven days a week. Patients, health care facility employees and other members of the public may file complaints about hospitals, ambulatory surgery centers, home health agencies, nursing homes, assisted living facilities, comprehensive personal care homes, adult medical day care, pediatric medical day facilities, and many other licensed acute- and long-term care facilities.
Hope this helps.
Thank you for reply which is comforting,and that I should not pay blindly for something I am definitely not sure that I owe. In the meantime, should I worry about the family member lost of eligibility and quality of care? He is bed ridden, attached to various life support, paralyzed from the neck down and blind and mute.
I feel that I have been involved in a web of lies and deception.
I sent to the center a last letter to the center quoting your reply and asking again for the Medicaid determination, instead I received a correspondence from their lawyer with a copy of 2012 determination that they always refused to give me (2013 was not included) the lawyer's letter stated that as have control of the familiy member assets and I refused to turn it over I may be subject to the Ombudsman investigation and or criminal prosecution, I am not sure what exactly is going , but my impression is that the lawyer did not get the full picture of the situation for whatever reasons that guide the Center's action.
thank you for you quick reply. To shed more light to the situation, I am a retiree living on a modest pension,which barely pay for the monthly bills the asset that they talked about is the family member $700 monthly social security income. When the family member, who is my spouse, got ill I was left with close to a million dollars in debt and in a pre-foreclosure status. In liquidating everything in the family's name I managed to avoid futher further proceedings. For your information the law firm specializes in debt recovery for nursing homes, probably by any mean necessary.
I do not know if the above will change the substance of your answer.
The main issue is that contradictory info I received last year, making me believe that I did not have to pay anymore and based on that information and the absence of billing I used the spouse ss to pay the house bills which still befall me. Now the backtracking is I have to pay retroactively even if I did not get the document in a timely manner . My concern is perhaps I may be accused of fraud or something of the sort and have to pay at once the whole amount of close to $7000 which I do not have.
Complaining is certainly an option but will it stop or even halt the process?
I was just summarizing our whole exchanges for you advice on the way forward. In a nutshell: First I was paying, then I was told I do not need to pay, then I was told I need to pay with retroactive effect for the 6 months I was not billed due to errors and negligence and added to that a 4 months of correspondence to have the justification for payment reinstatement which make it a retroactive payment of 10 months. In the meantime I used the funds as household income to pay bills. Now I am threatened with investigation and possible criminal prosecution by a lawyer who act more like an unscrupulous debt collector. My question is while considering filing complains as you suggested, is there a way out to stop or halt this process besides payment. And if this is the case arrangements will have to be made but with who.
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