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HCAOA Analyzing How CMS’s Newly Proposed Rules Would Affect Home Care Industry

5/3/2023

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Last week, the Centers for Medicare & Medicaid Services (CMS) unveiled two notices of proposed rulemaking (NPRMs), Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM), that together address access to and quality of care across Medicaid programs.
 
HCAOA’s Policy Committee is currently reviewing the proposed rules and will provide additional information.

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​If adopted as proposed, the rules would attempt to establish national standards for access to care regardless of whether that care is provided through managed care plans or directly by states through fee-for-service (FFS). Specifically, they would establish access standards through Medicaid or CHIP managed care plans as well as transparency for Medicaid payment rates to providers.
 
Within the HCBS realm, the proposed rule seeks to:
 
  • Establish a new strategy for oversight, monitoring, quality assurance, and quality improvement for HCBS programs;
  • Strengthen person‑centered service planning and incident management systems in HCBS;
  • Require states to establish grievance systems in FFS HCBS programs;
  • Require that at least 80% of Medicaid payments for personal care, homemaker, and home health aide services be spent on compensation for the direct care workforce (as opposed to administrative overhead or profit);
  • Require states to publish the average hourly rate paid to direct care workers delivering personal care, home health aide, and homemaker services;
  • Require states to establish an advisory group for interested parties to advise and consult on provider payment rates and direct compensation for direct care workers;
  • Require states to report on waiting lists in section 1915(c) waiver programs; service delivery timeliness for personal care, homemaker and home health aide services; and a standardized set of HCBS quality measures; and
  • Promote public transparency related to the administration of Medicaid‑covered HCBS through public reporting of quality, performance, and compliance measures.

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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
    • 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
    • Board of Directors
    • Staff
    • Caregiver of the Year Award
    • News Releases
    • Advertising & Marketing
    • The Voice
    • Contact Us
    • Jobs with HCAOA
  • Find a Job