Legislative Priorities
Advocacy in home care is essential for shaping policies that improve patient care and support the workforce. Your participation helps ensure that the voices of home care professionals are heard, driving positive change in the industry.
Federal Priorities
Federal Priorities Urge Your Congress to Delay 2025 Home Health Rate Cuts
Following the release of the Centers for Medicare & Medicaid Services (CMS) FY 2025 Home Health Final Payment Rule, HCA along with the National Association for Home Care and Hospice (NAHC) re-engaged with the sponsoring offices of the Preserving Access to Home Health Act (S. 4605/H.R. 8581) on refining the legislation to better its chances for passage before the end of the year, as well as strengthen transparency of the Centers for Medicare & Medicaid Services (CMS) in their rate-setting. Our champions on Capitol Hill are working to substitute this amended language in the negotiations for the year-end package. This amendment will not be introduced as new legislation.
While there won’t be a new bill to call for congressional action on, you can still advocate for this revised approach.
Please use the action alert below to write to your member of Congress urging them to support a year-long delay (2025) of CMS's proposed home health rate cut and call for added transparency in CMS rate-setting practices.
Tell Congress to Stop the Medicaid HCBS 80/20 Pass-Through!
In the Medicaid Access Rule CMS finalized a requirement that no less than 80% of all Medicaid payments, including but not limited to base payments and supplemental payments, be spent on compensation to direct care workers, for homemaker services, home health aide services, and personal care services. This requirement applies to services delivered under sections 1915(c), (i), (j), (k), and potentially also 1115 of the Social Security Act as well as those delivered through managed care contracts. Notably, it would not apply to 1905(a) State plan personal care and home health services.
The rule defines “compensation” narrowly as:
- Salary and wages;
- Benefits (such as health and dental benefits, paid leave, and tuition reimbursement);
- The employer share of payroll taxes for direct care workers; and
- Other remuneration as defined by the Fair Labor Standards Act
Use the link below to tell members of Congress to co-sponsor H.R. 8114, a bill that would prevent CMS from moving forward with a new requirement that Medicaid HCBS providers pass through 80% of their reimbursements to home care workers.
State Priorities
Enough Pay to Stay: A Bill to Reform Home Care Rate Setting Processes
Currently, agencies have been heavily reliant on non-guaranteed supplemental rate add-ons that have been passed by legislators through the state budget process. The Alliance has been actively working to pass legislation that would end the need for the Legislature to fund these supplemental rate add-ons for home care and home health workers every year. The goal is to ensure the existing rate setting process works and provides consistent rates that accurately reflect the true cost of providing home care and home health services to consumers across the Commonwealth.
This legislation would clarify the rate setting processes that are already in place for both home health and home care services. It does not set the rates or dictate the amount for future rates set by Mass Health and EOHHS. It would make the rate setting process more transparent and ensures rates set by the state follow the rate setting laws and reflect the actual operating costs incurred by home health and home care providers.
Licensure of Home Care Services
Massachusetts remains one of a handful of states without a licensure structure as a condition to provide home care services. In 2017, Governor Baker signed into law a framework for the Department of Public Health to establish a licensure structure for 'skilled' home health services. This framework did not include non-medical personal care services.
For many years, the Home Care Alliance has supported and advocated for legislation which would establish a licensure structure in Massachusetts. It is our vision that this regulatory structure would establish a baseline set of standards for home care agencies to comply with in order to lift up the industry at large and protect consumers.
Please use the link below to write to your state legislators urging them to support H.649, an Act to Improve Massachusetts Home Care, which would create a licensure system that would establish baseline standards for agencies, to ensure a quality network of providers for consumers and keeping services affordable for those who rely on them.
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Keeping up with changes in the home care industry is a challenge. That’s why Alliance members check their inboxes every Thursday for Update, our weekly e-newsletter. Each issue discusses the latest in regulatory and legislative changes, Alliance events and announcements, and featured ads from our popular job bank.
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