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NAHC Report: Issue# 2430, 5/15/2014
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
National Council on Medicaid Home Care Sends Letter to State Medicaid Directors on the Potential Effects that the Employer Mandate May Have on Home Care Paid for by Medicaid
NAHC Discusses MA Plan and Home Health Certification Requirements with CMS Officials
For Your Information: Voting Begins for Modern Healthcare’s 100 Most Influential People in Healthcare

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National Council on Medicaid Home Care Sends Letter to State Medicaid Directors on the Potential Effects that the Employer Mandate May Have on Home Care Paid for by Medicaid

NAHC’s affiliated National Council on Medicaid Home Care (The Council) recently sent a letter to all state Medicaid directors on the subject of the Affordable Care Act’s Employer Mandate and its effects on Medicaid. The Council’s Executive Director, William A. Dombi, sent the letter to all state Medicaid Directors to highlight, “a Medicaid impact of the Affordable Care Act that may have been overlooked, but is in need of quick and comprehensive action.”

According to the letter:

“The employer mandate under the ACA poses a serious threat to the future availability and quality of Medicaid home care services. A recently conducted survey of home care companies across the nation shows that well over three-quarters do not offer health insurance to their caregiver employees. As a result, these companies face a significant cost increase for compliant health insurance (approximately $2-3 an hour) or a $2,000 penalty for each full-time employee working 30 hours or more per week. Current Medicaid payment rates are insufficient to cover these added costs...      

Medicaid programs have increasingly rebalanced their spending on long-term services and supports towards home care and saved millions of dollars in doing so while enhancing the quality of life for Medicaid beneficiaries. To continue down this successful path, a remedy for the cost increases triggered by the ACA employer mandate must be found, and soon.

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NAHC Discusses MA Plan and Home Health Certification Requirements with CMS Officials

In the final call letter for the 2015 rates for the Medicare Advantage (MA) plans, CMS “clarified” that the MA plans were to apply the same certification requirements as fee-for-service (FFS) Medicare to plan members who receive home health services. The National Association for Home Care & Hospice (NAHC) has serious concerns with this directive.

Last week, NAHC discussed those concerns with officials at the Centers for Medicare & Medicaid Service (CMS) and questioned the rationale behind the requirement. NAHC expressed that the MA plans have a preauthorization process that negates the need to follow Medicare FFS certification requirements. In addition, NAHC interprets the regulation to require that the MA plans offer the same scope of benefits to its members as Medicare, but does not require that the plans apply the same certification criteria as Medicare. 

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Voting Begins for Modern Healthcare’s 100 Most Influential People in Healthcare

Voting is now underway for Modern Healthcare's 12th annual 100 Most Influential People in Healthcare program. Of the nearly 28,000 nominations submitted, the publication’s editors selected the top 300 names for the final ballot. Included on the final ballot is NAHC President Val J. Halamandaris.

Voting is now open and people can vote for their top five candidates. Their votes will count for 50% of the outcome; the other 50% will be based on the expert opinions of the senior editors at Modern Healthcare.

The combination of readers' votes and the editors' choices will determine the final ranking of the 100 Most Influential People in Healthcare, which will be published this summer.

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