The Centers for Medicare & Medicaid Services would be prohibited from implementing the Medicaid Access Rule under a bill introduced last week in the House of Representatives.
The legislation has support from the senior living industry.
The final rule, formally named the Medicaid Program; Ensuring Access to Medicaid Services rule, was released April 22 and requires in part that at least 80% of Medicaid payments for homemaker, home health aide and personal care services be spent on compensation for direct care workers. It also contains quality measures for providers of home- and community-based services. The rule is expected to be published in the Federal Register May 10 and would go into effect July 9.
Saying that the rule would require states to spend “billions in new, unfunded mandates or force home- and community-based service providers to reduce access to care for those who need it most,” US Rep. Kat Cammack (R-FL) introduced HR 8114 April 25. Her bill and other long-term care-related bills focusing on increasing Medicaid access and improving program integrity will be at the center of a House Energy and Commerce Committee hearing on tomorrow.
The National Center for Assisted Living said it was glad to see Congress focusing on workforce development and Medicaid access, and the association encouraged House committee members to consider the full effects that decisions made in Washington, DC, have on senior living communities.
“We support the advancement of Rep. Cammack’s bill to prevent the finalization of the 80/20 provision of the Medicaid Access Rule,” NCAL Executive Director LaShuan Bethea told McKnight’s Senior Living. “We ardently support increasing wages for direct care workers, but mandating that a certain percentage of Medicaid reimbursement be allocated to wages does not address the core problem of chronic Medicaid underfunding.
“Because all states have a different methodology for reimbursement, there is no consistency on how this will impact the workforce, and there is no data or research to support this as an adequate workforce solution for recruitment and retention.”
LeadingAge said the need for codifying the 80/20 passthrough remains unsupported by data or an infrastructure to collect data that could support a threshold.
“It remains unworkable for members with no commitment of funding from the federal administration or states, and will disproportionately harm small and rural providers,” LeadingAge Director of Medicaid Georgia Goodman told McKnight’s Senior Living.
“LeadingAge broadly supports the efforts of the finalized rule to improve access, quality and accountability in Medicaid programs through enhancements in transparency and reporting by states,” Goodman added. “Rep. Cammack’s bill is appropriately targeted at the problematic provision within the regulation, though we believe a small, but consequential, edit may be necessary to include all waiver authorities covered under the regulation.”
The Medicaid Access Rule was part of a flurry of federal rules affecting senior living providers that were announced last week. The Department of Labor announced a new threshold for over time pay eligibility, and the Federal Trade Commission issued a ban on noncompete agreements.
The week also saw CMS release its final minimum staffing mandate for nursing homes. That rule applies directly only to nursing homes, but senior living providers expect it to increase their staffing challenges, too, given that they hire caregivers from the same pool of candidates.
All of those rules already have faced or are expected to face legal challenges.
