House Medicaid Task Force Working on Proposals for 2017
May 23, 2016 11:33 AM
Last year, Republicans in the U.S. House of Representatives announced the establishment of the Medicaid Task Force to examine and develop changes to the Medicaid program. The Task Force is chaired by Rep. Brett Guthrie (R-KY). Subsequently the National Association for Home Care & Hospice (NAHC) has met him and his staff to discuss Medicaid-related and other legislation.
Rep. Guthrie, according to news reports, recently said that the Medicaid Task Force is working on proposals but will not release them until 2017. This will allow the Task Force to wait until after the national elections have determined control of Congress and the White House. Rep. Guthrie also indicated that reducing costs in Medicaid is one of the focuses of the Task Force. The National Association for Home Care & Hospice (NAHC) has argued for the expansion of home and community based services in Medicaid, which are not only higher quality and preferred by those receiving care but also more cost-effective than institutional care.
NAHC has also expressed concerns to Rep. Guthrie regarding legislation that he has introduced that would require states to use electronic visit verification (EVV) for Medicaid personal care services (H.R. 2446). While NAHC favors program integrity, NAHC expressed concerns about the legislation’s current approach as it may affect provider costs and multi-state organizations. NAHC worked with the Committee and provided recommendations to improve on the legislation as well as information of interest to the Committee about the use of EVV among personal care providers.
For example, NAHC presented the following Medicaid home care priorities at the 2016 March on Washington conference:
Position Medicaid home care providers as strategic partners and advocates for home care programs within Medicaid managed care organizations
Congress should require that any LTSS Medicaid managed care program develop an Olmstead compliance plan, maintain or expand the home care benefits previously provided by the state, comply with the fee-for-service quality of care standards, and ensure enrollees choice among home care providers. Additionally, CMS should create a program of federal oversight to monitor the compliance of managed long term services and supports programs with respect to payment, network and care adequacy as currently done for Medicare Advantage plans.
Protect and expand access to mandatory Medicaid home care and hospice benefits
Congress should establish a mandatory Medicaid home care and hospice benefit. Congress should also set minimum standards regarding the scope of such benefits.
Congress should continue its work in combating waste, fraud, and abuse in our nation’s health care system by requiring CMS to promulgate model minimum standards for compliance and program integrity, with adequate financial support for all parties.
Engage with stakeholders to develop and advocate for national uniform data sets and measurable quality outcomes in Medicaid home care, in both fee for service and managed care
Congress should require that CMS work with stakeholders to devise appropriate quality standards for long term services and supports as well as minimum mandatory uniform data sets that would be required of state Medicaid programs to measure the care and cost effectiveness of long term services and supports.
Ensure appropriate reimbursement rates as well as fair and appropriate compensation and benefits for Medicaid home care staff.
Congress should enact legislation that requires that states continually assess the adequacy of Medicaid home care and hospice rates of payment and the methodology utilized for establishing rates to prevent any loss in access to care.
The longstanding companionship services overtime compensation exemption, as applied to home care under Fair Labor Standards Act, should be restored to the standards in effect from 1975 to 2015 as Medicaid programs are not prepared to absorb additional costs triggered by the regulatory change. Alternatively, Congress should ensure that Medicaid adequately reimburse employers for any added costs of overtime compensation and enact reforms to the FLSA that establish a reasonable compensation structure that recognizes the unique aspects of care in the home.