Louisiana’s nursing homes will lose $20.3 million in Medicare funding, the sixth-largest cut nationwide, as a result of the “bad debt” provisions in the Middle Class Tax Relief and Job Creation Act of 2012, according to an analysis by Avalere Health.

The analysis was funded by the Alliance for Quality Nursing Home Care.

In a news release, Alliance President Alan G. Rosenbloom said the bad debt provision is a misnomer.

“Nursing homes in Louisiana have no legal recourse to collect ‘bad debt’ from the Louisiana Medicaid agency -- and is more accurately described as ‘uncollectible debt’ as mandated by federal law,” Rosenbloom said. “We must continue to reinforce this fact with congressional leaders, and respectfully encourage Louisiana lawmakers to keep this in mind as the budget process progresses.”

Rosenbloom said three out of four Louisiana nursing home patients’ care is paid for by Medicare and Medicaid.

The new federal Medicare cuts upset nursing homes’ already fragile funding environment, he said.

Medicare reimburses health care providers anywhere between 70 and 100 percent of bad debt from eligible patients who fail to pay their deductible or co-pays. Under the new law, that percentage will be cut to 65 percent across the board.

According to the Avalere Health analysis, the “bad debt” cut for nursing homes hit Florida nursing homes the hardest, with a $60.5 million reduction. The other states losing the most money were Ohio, $30.5 million; Illinois, $28.8 million; Pennsylvania, $24.2 million; and North Carolina, $22.6.