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Fact Sheet Now Available on Proposed Medicaid 80/20 Proposed Rule

8/23/2023

8 Comments

 
HCAOA continues efforts to highlight the negative impact of CMS’ proposed rule that would require states to ensure at least 80 percent of all Medicaid HCBS payments are spent on compensation for direct care workers, such as nurses, home health aides, and others who directly support Medicaid beneficiaries in activities of daily living at home. The remaining 20 percent of payments would be expected to cover all other HCBS operating expenses.
Last month, HCAOA and NAHC submitted comments on the rule in a 75-page document that emphasized the industry’s support to increase wages of direct care workers but challenged the 80/20 proposal citing a lack of data to support and implement the proposal, particularly in rural areas.

A fact sheet is now available, highlighting several state Medicaid officials’ comments and opposition to the rule. Members are encouraged to use the fact sheet in advocacy efforts to oppose this rule.
8 Comments
Elena
8/23/2023 11:12:53 am

Good day, thank you for allowing me to share my opinion about the funding. Each state has a different income and the budget. Each state is subsidies differently. The rule of the 80% is a risk factor for many elderly and disabled. Some of the elderly have a spend down or a a low monthly retirement that is not enough to cover expenses not to mention the HomeCare inquiry. Did you know that sending the seniors to the rehabs and nursing homes will over charge the state’s and federal budget? Most of the seniors are born and worked in United States. They paid their taxes to the government so others can rely on their need . Not it’s your mission to pay them respect and subsidize their needs they deserve. The social service theme must stay humanity and fair. We all vote for our taxes to support the economy and social services and NOT the war. I oppose the idea of the states to pay the 80% .. what if CT can and other states cannot? Each state is booming with the baby boomer growth. The social service is key ! The care at home is vital! I hope that the lawmakers have guts to stand up for the hard working and disabled people. Seniors are vulnerable. Has a democratic value changed its’ course?

Reply
Home Care Association of America
8/23/2023 01:29:10 pm

Hi Elena, thank you for sharing your opinion with us. We will certainly incorporate your comment into our advocacy moving forward. If you want to discuss this further, HCAOA's CEO, Vicki Hoak, has invited you to contact her at vicki@hcaoa.org.

Reply
Stephen Tweed link
8/23/2023 02:25:49 pm

Data gathered from our research at Leading Home Care, along with our member benchmarking at the Home Care CEO Forum suggest that this new rule will create unintended consequences for state Medicaid Programs, as home care providers will be unable to sustain operations and keep caregivers employed.

The proposed 80% rule will cut gross margins for home care companies to the point that many companies, particularly smaller companies, will stop providing care to Medicaid beneficiaries. In many areas of the country, beneficiaries are already being turned down for care because local agencies cannot find caregivers to staff the cases.

We appreciate the work that HCAOA is doing to communicate with legislators and regulators on this issue, and also what you are doing to address the caregiver shortage. Thank you.

Reply
Home Care Association of America
8/23/2023 02:58:37 pm

Thank you for your support of HCAOA, Stephen. Your comment will be included into our advocacy as well.

Reply
Jason Tweed link
8/23/2023 03:47:57 pm

The Proposed 80/20 rule is irresponsible and dangerous in my opinion. Almost no agencies could be profitable with only 25% markup above cost, and even those that could squeak out a profit, it would be fractional compared to the potential profits of private pay home care. No agency in their right mind we continue to provide services to Medicaid waiver clients. The 80/20 rule would only be viable for self-directed care, putting the onus and risk directly on the shoulders of the users and their families. It's hard enough to find high quality care when you have the benefit of professionals supporting you. As a user of home care services I am vehemently opposed to this proposed change.

Reply
Edward
8/24/2023 12:35:12 pm

Is the 80% allocated for 'compensation for direct care workers' inclusive of benefits and FICA tax contributions?

Reply
Home Care Association of America
8/24/2023 03:24:55 pm

Hello Edward, Great question. Taxes would be included however, benefits such as insurance, Workers’ Compensation would NOT be included and would have to come out of the remaining 20%. If you have additional questions or would like to speak with someone directly please don't hesitate to contact HCAOA at info@hcaoa.org and we will get back to you.

Reply
Edward
8/24/2023 04:26:04 pm

Thanks

Reply



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  • Membership Resources
    • Member Login
    • Code of Conduct
    • Resources
    • Newsletters
    • Product & Services Guide
    • Join HCAOA
    • Benefits: Agency Membership
    • Benefits: Associate Membership
  • State Chapters
    • Alabama
    • Arizona
    • California
    • Connecticut
    • Florida
    • Georgia
    • Illinois
    • Michigan
    • New Jersey
    • New York
    • Ohio
    • South Carolina
    • Tennessee
    • Texas
    • Virginia
    • Washington
    • West Virginia
    • Wisconsin
  • Education/Events
    • Calendar
    • National Home Care Conference >
      • Thank You to Our Sponsors!
  • Advocacy/Policy
    • Home Care Workforce Crisis: An Industry Report and Call to Action
    • Bring the Vote Home
    • Advocacy Fund
    • State of Home Care: Industry at Crossroads
    • Home Care Workforce Action Alliance
    • Caring for Seniors: Value of Home Care
    • Home Care by the Numbers
    • Issues & Positions
    • Legislative Action Network
    • State Legislation Tracker
    • Federal Legislation Tracker
    • 2023 Federal Advocacy Day
  • About HCAOA
    • Mission & Vision
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      • 2024 Board of Directors Candidate Form
    • Staff
    • Caregiver of the Year Award
    • News Releases
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