​Medicaid Proposed Rule Discussed During National Webinar

​Last week, the Medicaid Proposed Rule was discussed during the Polsinelli, HCAOA and NAHC quarterly webinar. HCAOA Board Treasurer Matt Kroll of BAYADA participated on the panel, which focused on the impact of the rule on home care agencies participating in Medicaid’s HCBS program. ​An overview of the proposal was also provided to webinar participants. 

 
Here are the highlights of the proposed rule: 

• Consists of two regulations: One on Access and the other on Medicaid Managed Care
• Affects Medicaid HCBS Providers including homemaker, home health aide, and personal care. Home health, which is a mandated service for all state Medicaid plans is NOT affected as well as personal care IF it is included in your respective Medicaid state plan.
• The following services are included in the proposed rule:  Medicaid HCBS Waivers 1915c, 1915 I, 1915 j, 1915K.

Positive Elements of Proposed Rule:   

• Payment Rate Transparency Measures
• Grievance Process/Incident Management
• Advisory Council for Stakeholder Input
• Revamping Quality Reporting System for HCBS

 
However, the requirement mandating that 80% of Medicaid reimbursement goes to worker compensation is so significant, that the good is overshadowed by this requirement. Under the proposal, compensation includes salary, wages, OT, health insurance, sick leave, mileage reimbursement, payroll taxes. Everything else would fall under the remaining 20% including workers’ compensation, unemployment insurance, supervision, scheduling, training, IT and other administrative functions.

During the panel, Kroll urged all agencies providing Medicaid HCBS to send comments to CMS. HCAOA members interested in submitting a comment may do through the online Legislative Action Center. 

HCAOA has formed a workgroup tasked with developing comments on the proposed rule and is partnering with NAHC on a formal, written comment to CMS. Members of the HCAOA Medicaid Access workgroup include Ford Allison of TEAM Services Group, Veronica Charles of Maxim, Jim Fetzner of Long-Term Care and Medicaid Innovations, Ryan Green of BrightSpring Health, Bryant Greene of Always Best Care Senior Services, Dave Lamb of CareMaster Medical Services, Matt Walker of Village Caregiving, and Jeff Wiberg of Family Resource Home Care.