Eleven U.S. senators are calling on CMS to delay its proposed Medicaid salary requirements until more data is available and released on the impact to providers and patients’ access to care.
 
Expected to be finalized in the coming weeks, the Ensuring Access to Medicaid Services proposed rule released last April included a requirement 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.
 
“There has been no official data analysis of how this proposal would impact the Medicaid system, and payors and states alike have flagged that they expect it will harm provider networks and beneficiary access,” reads the letter from the senators.
The letter asks CMS to not move forward with the final rule, currently in the final phase of the approval process. Instead, they are asking CMS to:
 
1) Collaborate with states and stakeholders as well as federal resources like MACPAC to assess Medicaid data on payment rates to home care, home health, and homemaker services and the potential impact of the HCBS payment adequacy proposal on access to beneficiaries, provider networks, workforce outcomes, and state operations.
 
2) Work with MACPAC to implement the recommendation to create a stakeholder and interagency evaluation of the impacts on payment, data, and other outcomes of defining the direct care workforce.
 
The senators signing the letter included:
  • Marsha Blackburn, R-Tenn.
  • Ted Budd, R-N.C.
  • Shelley Moore Capito, R-W.Va.
  • Steve Daines, R-Mo.
  • James Lankford, R-Okla.
  • Markwayne Mullin, R-Okla.
  • Dan Sullivan, R-Alaska
  • Tim Scott, R-S.C.
  • John Thune, R-S.D.
  • Thom Tillis, R-Fla.
  • Roger Wicker, R-Miss.