Proposed HCBS Rule Could Diminish Service Access, Hamper Provider Retention Efforts, 11 Senators Tell CMS

McKnight’s Senior Living | By Lois Bowers
 
A proposed federal rule that would require providers of home- and community-based services to spend at least 80% of the Medicaid payments they receive for personal care, homemaker and home health aide services on compensation for direct care workers could diminish older adult access to services and hamper providers’ workforce retention efforts, 11 Republican senators told the administrator of the Centers for Medicare & Medicaid Services on Thursday.
 
“We have significant concerns that the proposal could and will likely harm access for seniors and people with disabilities, particularly in rural regions of the country, as well as harm workforce retention and provider networks,” the senators wrote CMS Administrator Chiquita Brooks-LaSure in a letter.
 
The missive was signed by Sens. Marsha Blackburn of Tennessee, Ted Budd of North Carolina, Shelley Moore Capito of West Virginia, Steve Daines of Montana, James Lankford of Oklahoma, Markwayne Mullin of Oklahoma, Tim Scott of South Carolina, Dan Sullivan of Alaska, John Thune of South Dakota, Thom Tillis of North Carolina and Roger Wicker of Mississippi.
 
CMS proposed the “Medicaid Program; Ensuring Access to Medicaid Services” rule in April. The proposal, which also would mandate quality measures and make other changes to the HCBS program, was sent to the White House Office of Management and Budget in January, and CMS has indicated that it plans to issue a final rule by April.
 
The 11 lawmakers recommended that CMS assess Medicaid data through collaborations with states and other stakeholders, as well as federal resources such as the Medicaid and CHIP Payment and Access Commission, and then work with MACPAC “to create a stakeholder and interagency evaluation of the impacts on payment, data and other outcomes of defining the direct care workforce.”…

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