Proposed Changes to Home- and Community-Based Services:

What to Know

by Dave Turgeon, Managing Director and Jack Turgeon, Senior Consultant

The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule for home- and community-based services (HCBS) that would make major changes to the way home care workers are compensated under Medicaid. What’s most significant about the proposed changes is the requirement that at least 80% of the Medicaid payments for personal care, homemaker, and home health aide services must be directed toward the wages for caregivers.

The new “80% rule” is not the only change proposed as the proposed rule is over 400 pages. It is just the one getting far more attention than any other. Officials have stated that one of their objectives with the proposed changes is to help address the workforce challenges plaguing the industry.

While it’s noteworthy and perhaps commendable of CMS to be thinking of workforce challenges, the proposal in its current form is not without challenges. Industry experts have been offering different perspectives. We’d like to highlight some of the commonly voiced issues and offer some of our own.

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