Connecticut Legislative Committees Approve Medicaid Rate Increase

​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.

HCAOA Connecticut submitted testimony in support of the rate increases.
 
The amendments were filed by the Department of Social Services and are required for the state to receive CMS’s approval of the American Rescue Plan Act prior to implementation of the plan and expenditure of any ARPA funds, as
DSS Commissioner Deidre S. Gifford, MD, MPH, explained in her testimony. ARPA provides states with a temporary 10% increase to the federal medical assistance percentage for certain Medicaid HCBS expenditures. CMS conditionally approved Connecticut’s ARPA plan on December 23, 2021.
 
The applications will enable implementation of several improvements for providers, including:

• One-time lump sum stabilization payment calculated at 5% of SFY 2021 expenditures; and
• Rate increases of 3.5%, retroactive to July 1, 2021, in existing rates approved by CMS for all provider types and services; 6% for agency-based PCAs related to the costs of complying with the state’s increase in the minimum wage, retroactive to August 1, 2021; and 1% enhanced performance-based supplemental payments for all services. In June, the legislature approved a 1.7% rate increase that has not yet been distributed.

The committees’ approval followed a public hearing in which HCAOA Connecticut DSS Medicaid committee chair Marlene Chickerella, managing partner of B&M Homemaking and Companion Services, LLP in West Haven, testified in support of the proposed increases. Ms. Chickerella discussed the practical impact of ongoing minimum wage increases on her agency’s workforce and implementation of the rate increases and the importance of the state implementing a long-term, sustained solution to Medicaid.
 
“Today, many agencies have stopped taking new clients and some are stopping select services,” said Ms. Chickerella. “The decision to do this was not an easy one, acknowledging the impact on our clients and our staff. Some agencies may even be forced to close their doors. The State will quickly find [itself] paying much more and for the wrong service. Medicaid will be forced to fund unnecessary and expensive institutional care instead of appropriate, desirable and low-cost home care… The people most impacted are the ones that are the most vulnerable.”
 
Ms. Chickerella helped frame the debate for the committees, whose members challenged DSS on the process for establishing a permanent rather than temporary rate increase. DSS Deputy Commissioner Michael Gilbert assured the committees that the rate increases, with the exception of the one-time, 5% supplemental stabilization payment, are “ongoing, so they will continue and they are projected as such; they’ve been incorporated into the estimates” the Department has been working with.
 
Rep. Jay Case (R-Winsted), ranking member of the Human Services Committee, pressed the Department about the precise total amounts currently being funded, which is $75 million, in order to provide for workers who care for the most vulnerable. “Those workers need to have a permanent solution,” he said. DSS indicated it plans to renew funding requests in the upcoming state budget so the rate increases can continue. “There certainly is an expectation and a commitment to continuing these rate increases even though this is a temporary authority,” Mr. Gilbert clarified.
 
DSS expects a “fairly rapid turnaround, a matter of a couple of weeks by our Federal partners and then we will be able to implement the payment increases,” the Commissioner stated.