​The South Carolina Department of Health and Human Services (SCDHHS) is increasing specific reimbursement rates for personal care and nursing services for State Plan and home and community-based waiver services (HCBS).

​Thousands of Georgians have had continuous Medicaid coverage stemming from the ongoing federal COVID public health emergency (PHE). However, when the PHE expires, states must conduct redeterminations of Medicaid recipients to check their eligibility. Georgia Medicaid recipients will soon receive one or more text messages from the Georgia Department of Human Services asking them to update their account information and communication preferences. The timeline for expiration remains uncertain, but Medicaid recipients are strongly encouraged to review and update their information now.

​In Performance Year 7 of the Independence at Home (IAH) Demonstration (2020), CMS found that the expenditures for IAH practices’ applicable beneficiaries were approximately 18%, or equating to $42.3 million below their spending targets, an average reduction of $6,585 per beneficiary. All 10 IAH participants (nine practices and one consortium) reduced the per-beneficiary-per-month (PBPM) expenditures relative to the practice’s PBPM spending target. A total of 6,436 beneficiaries were enrolled in the demonstration at 10 participating practices.

The Department of Health and Human Services (HHS) and CMS announced that the deadline for states to use funding from the American Rescue Plan (ARP) has been extended to March 31, 2025. The ARP provided states with a temporary 10 percentage point increase in federal Medicaid funding for HCBS if they meet certain requirements. The original deadline was March 22, 2022.

The additional federal funding made available under the ARP allows those enrolled in Medicaid who need long-term services and supports to receive assistance required to reside in the setting of their choice.
 
States are using the funds in a variety of ways to enhance, expand, and strengthen home and community-based services. Some are using the additional funds to increase HCBS to help people with Medicaid coverage receive care outside a skilled nursing facility after a hospitalization. Others are providing recruitment and retention bonuses and increasing pay for direct support professionals and implementing new training programs and other strategies to strengthen the direct support workforce. Click here for details about how states are using the funds. 

HCAOA has been working with legislators to support legislation that would provide tax incentives for home modifications so seniors and those with disabilities can more easily and safely continue living in their own homes.
 
U.S Representatives Charlie Crist (D-FL) and Thomas Suozzi (D-NY) introduced the Home Modification for Accessibility Act, legislation that would provide a lifetime $30,000 tax credit to cover the costs associated with aging-in-place modifications to homes. The act also creates new jobs for the U.S. economy.
 
The tax credit would be refundable and transferable so that even low-income seniors and those on a fixed budget would be able to take advantage of the credit immediately. The bill would lower Medicaid long-term care expenditures as more seniors can age in place and would decrease Medicare expenditures by reducing preventable injuries that occur in the home.
 
“This bill will help correct a fundamental injustice in American life. While we’re living longer and healthcare is increasingly conducted at home, the country’s housing stock is not meeting our daily and safety needs,” said Tenenbaum.
 
“Incentives outlined in this bill will encourage people to demand building and renovation designs that support aging in place with joy, dignity, and independence. Over time, these features will become the norm, benefiting individuals, families, the healthcare system, and our economy.”

HCAOA CEO Vicki Hoak spoke with McKnights Home Care about the need to continue to elevate home care in a post-pandemic world by establishing a national quality standard and implementing immigration reform. She also discussed how critical it is to make it easier for Medicaid to pay for home care.
 
Listen here.

​The Agency for Health Care Administration (AHCA) recently held a standard rule making meeting related to revising the Medicaid fee schedule. To see the current and initial proposed fee schedule for Medicaid, please click here.
 
As the HCAOA Florida Chapter prepares to meet with AHCA to discuss the rate increase, we are looking for feedback from ALL home care providers (whether you provide Medicaid services or not).
 
Please click here to complete a very brief survey by next Wednesday, April 20 at 5 p.m. ET. 

CMS announced it will offer more than $110 million to expand access to home and community-based services (HCBS) through Medicaid’s Money Follows the Person (MFP) program. The new Notice of Funding Opportunity (NOFO) makes individual awards of up to $5 million available for more than 20 states and territories not currently participating in MFP. 

​These funds will support initial planning and implementation to get the state/territory programs off the ground, which would ensure more people with Medicaid can receive high-quality, cost-effective, person-centered services in a setting they choose. For states already participating in MFP, CMS also announced that the agency is increasing the reimbursement rate for MFP “supplemental services.” These services will now be 100% federally funded with no state share.
 
HCAOA supports this program, which has helped thousands of older adults seamlessly transition from a nursing home or institution back into their own homes. In 2020, more than 10 state chapters penned letters to their state Medicaid Directors in support of the program.

​Last week, the Senate Special Committee on Aging held a hearing entitled “An Economy that Cares: The Importance of Home-Based Services.” Led by Committee chair Sen. Bob Casey (D-PA), the hearing focused on the dire need for investment in the Medicaid Home and Community-Based Services (HCBS) program. 

​SCDHHS is accepting public comments through March 28 on its 1915(c) Home and Community-Based Waiver Amendments, which establish authority for the use of enhanced funding from Section 9817 of the American Rescue Plan Act (ARPA). These amendments will address cost limits and services to account for impacts associated with COVID-19 and will make permanent the rate increases implemented under the recently approved Appendix K.

​Last week, the Georgia House of Representatives approved HB 911, the SFY 2023 Budget. This House-approved budget includes $1,994,623 in state funds ($5,906,494 in total funds) to increase the Medicaid Elderly and Disabled reimbursement rate for all home and community-based providers.  The HCAOA Georgia Chapter had originally submitted an ask for a 3.0% rate increase at a meeting of the House Appropriations Health Subcommittee. Our testimony was one of more than twenty requests for funding above the original Governor’s budget, requests that in total created more than $150 million in additional requests for budget funding.  As a result of these many requests, we were advised to reduce our ask and direct its intent to cover the costs of fingerprinting that was added as a regulatory requirement in 2019.  That change was made, and our ask was resubmitted and eventually included in the budget.

After many hours spent advocating by HCAOA Connecticut Chapter members for higher, more equitable Medicaid reimbursement rates, the Department of Social Services has at long last updated the rates for several service providers, including Connecticut Home Care and Personal Care Assistant. Last week, the Department said it is continuing to work through the approval process for provider rate increases with the Centers for Medicare and Medicaid Services (CMS), and its approval is anticipated very soon.

​Last week, HCAOA released “State of Home Care: Industry at a Crossroads” during a special livestream event featuring members and caregivers. This new report spotlights data and industry challenges, calls on home care industry leaders and policymakers to unite around six policy priorities that address the rapidly growing demand for care and to help Americans age in their own homes with comfort, safety and independence.

In recent years, an increased number of HCAOA members are providing Medicaid-funded Home and Community-Based Services. In fact, several HCAOA state chapters have mounted campaigns to advocate for Medicaid rate increases. Last month, CMS released a report on Medicaid Long-Term Services and Supports Expenditures in 2019 that provides in-dept information on states’ spending for Home and Community-Based Services and other senior programs. Here are some highlights from the report:

​Last Thursday, the Connecticut Legislature’s Appropriations and Human Services committees approved the submission of federal Medicaid applications to the U.S. Centers for Medicare and Medicaid Services for emergency preparedness home and community-based services waiver amendments and Medicaid disaster relief State Plan Amendment, to enable the state to provide rate increases to providers and new services to address gaps in current HCBS continuum of supports.