In May, the Centers for Medicare and Medicaid Services issued a Notice of Proposed Rulemaking, “Ensuring Access to Medicaid Services.”  The 130-page proposed rules would establish access standards, transparency for Medicaid payment rates to providers, and set requirements regarding compensation percentages for wages for direct care workers in Home and Community Based Services including 1915c waivers, personal care service, among other things.  This CMS Fact Sheet describes the proposed rulemaking.

CMS proposes to make the following changes to HCBS services including 1915c, personal care services, homemaker and home health aide services:

• “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.”

We are currently drafting ACCSES’s public comment, but your insights, experience, and knowledge will be invaluable.  The public comment period closes on July 3, 2023 and we encourage you also to submit a comment on how your organizations, staff, and the people you serve would be affected by this rulemaking.  This session will be led by Thomas Cook, Chair of ACCSES’s Long Term Services and Supports Committee.  It is open to all ACCSES members.  Register for the Zoom event here.