Winning Wheels rehab facility waits on Medicaid funding

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PROPHETSTOWN, Ill (KWQC) -- Some healthcare workers in Illinois say the state has missed a major Medicaid deadline that's costing their facility thousands of dollars.

Winning Wheels, a rehabilitation facility in Prophetstown, has sent over a dozen applications for Medicaid funding and say they haven't heard back from the state.

Winning Wheels Administrator Amie Behrens says, "the phone system is automated, so you will sit on hold for 30, 40, 50 minutes to an hour and you will not receive anybody on the other end."

Behrens says they submitted Medicaid applications for seven patients back in late June and 45 days later on August 1st, they received no word from the state on those applications and are still waiting. Behrens says the state is required to make a decision on whether or not to approve Medicaid funding within 45 days of receiving the application.

"Our Medicaid applications for our new residents that are coming into our facility are not being processed timely," said Behrens.

The facility has another seven people who lost Medicaid funding entirely, requiring another seven applications. Behrens says this means the facility cannot bill those residents and Winning Wheels does not receive payment from them.

"95 percent of our resident population are funded by Medicaid so when Medicaid doesn't pay, its a financial burden for the facility," said Behrens.

With 15 residents total without Medicaid to cover their costs at Winning Wheels, the facility absorbs those payments, costing the facility 20 percent of their monthly revenue or roughly 80,000 dollars. Without those payments, the facility fears it will fall behind in payments to vendors who provide medical supplies, food and therapy residents rely on.

Behrens asks, "If we're losing payment for these people today, for July's month of services, what is August going to look like?"

This week, Winning Wheels reached out to State Representative Tony McCombie's office for help getting those Medicaid applications to the state. A spokesperson from McCombie's office says the process for approval has problems they hope to overcome, but warn it is a long process.

At this time, Winning Wheels says there are no immediate concerns about closing the facility.