Rule
would allow deductions from state Medicaid payments to pay for health
insurance and other benefits on behalf of certain Medicaid practitioners
The
Centers for Medicare & Medicaid Services (CMS) proposed a rule today
which would enable states to make payments to third parties on behalf of
certain individual health care practitioners, including home care workers
and personal care assistants. These changes would make it easier for those
workers to obtain and retain health insurance, training, and other employee
benefits, fulfilling a key promise made by President Biden on the campaign
trail to support home care workers. The rule, if finalized, would foster a
stable and qualified health care workforce by making it easier for such
practitioners to access benefits customary for full-time employees.
Today’s
rule proposes to allow Medicaid state agencies to make deductions from
Medicaid payments due to certain individual practitioners in order to make
payment to third parties on behalf of those practitioners for typical
employee benefits, if the practitioner has consented to such deductions.
This rule would apply to the class of individual practitioners for whom
Medicaid is their primary source of revenue. Many of these workers provide
home and community-based services. These practitioners serve our most
vulnerable individuals where they are enabling Medicaid beneficiaries to
remain in their homes and communities. These changes would make it easier
for these practitioners to enroll in, or pay for, customary employment
benefits like health insurance and skills training. The rule would also
help state Medicaid agencies by easing administrative burden, while
providing additional flexibility to operate their programs more efficiently
and effectively.
The
Reassignment of Medicaid Provider Claims proposed rule comes in response to
a 2020 United States district court ruling that vacated a 2019 final rule.
The 2019 rule prohibited states from making these types of payments to
third parties. Today’s proposed rule would reestablish this payment
flexibility.
Flexibility
is at the core of this rule. State agencies not seeking to make these third
party payments on behalf of individual practitioners would not face any new
administrative burden.
To
view the Proposed Rule, please visit: https://www.federalregister.gov/public-inspection/2021-16430/medicaid-program-reassignment-of-medicaid-provider-claims
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