On July 14, The Centers for Medicare & Medicaid Services (CMS) announced in a letter to state Medicaid Directors that the deadline for compliance with the Home and Community Based Services (HCBS) Settings Rule will be extended until March 17, 2023 due to the COVID-19 pandemic. The previous deadline was March 17, 2022. The HCBS Settings Rules requires all settings funded by Medicaid HCBS programs to, among other things, provide opportunities for participants to be integrated in and engage in community life, have access to the community, control their personal resources, and seek employment and work in competitive settings.
On July 17, the Senate approved H.R.6042 without amendment by unanimous consent. This bill delays by one year electronic visit verification (EVV) requirements for tracking when personal care services are provided to people with disabilities. The bill also expresses the sense of Congress that the Centers for Medicare and Medicaid Services (CMS) should hold at least one public meeting and solicit ongoing stakeholder input on its recently-issued guidance. The House of Representatives passed this bill last month. The bill now awaits President Trump’s signature. The Arc applauds passage of this bill which gives advocates more time to work with CMS and state Medicaid agencies to ensure EVV is implemented in a way that doesn’t place an undue burden on providers and protects the privacy of beneficiaries.
The Centers for Medicare and Medicaid Services (CMS) is in the process of distributing newly-designed Medicare cards. As part of the Medicare Access and CHIP Reauthorization Act of 2015, Congress mandated the removal of Social Security numbers from Medicare cards to guard against identity theft. The new cards contain a unique Medicare number for each individual. Cards are being mailed out between April 2018 and April 2019 on a schedule organized by state of residence. Learn more here.
On May 16, the Centers for Medicare and Medicaid Services (CMS) issued guidance on implementation of electronic visit verification (EVV) required in the 21st Century Cures Act. Congress directed CMS to issue this guidance at least one year before the implementation deadline of January 19, 2019. The statute requires EVV for personal care services and home health services. However, the guidance provides a very expansive interpretation that includes any service where assistance with activities of daily living or instrumental activities of daily living is provided in part in the home. Furthermore, it leaves many decisions with privacy implications up to states. The Arc believes the short time frame is insufficient for states to engage with stakeholders to implement these requirements in a way that does not put an undue burden on providers and does not violates the privacy of beneficiaries.
On April 9, the Centers for Medicare and Medicaid Services (CMS) released a final rule weakening consumer protections in the Affordable Care Act. The final rule increases the amount by which insurers can increase premiums without regulatory approval, from 10% to 15%. Furthermore, it exempts student health plans from this process. The rule also broadens the circumstances when plans are allowed to spend less than 80% of premiums on providing care without being required to reimburse beneficiaries. Additionally, it allows states to narrow the scope of essential health benefits that plans are required to cover. Learn more about the final rule here.
Last week, the House and Senate advanced the most important spending bills for disability programs – Labor, Health and Human Services, Education, and Related Agencies (L-HHS-ED). Both would maintain overall sequestration funding levels and include a number of substantial cuts to programs, earning the promise of a veto by President Obama.
L-HHS-ED – Senate – The Senate bill passed the Appropriations Committee along party lines on June 25. The bill’s discretionary funding level is $3.6 billion below the Fiscal Year (FY) 2015 enacted level and includes numerous policy riders that would limit the activities of federal agencies. Several federal agencies would receive significant cuts and a small number would receive increases. Notable examples include:
- LABOR: Includes a 4% cut for Workforce Innovation and Opportunity Act (WIOA) programs.
- HHS: Includes a 28% cut for the Centers for Medicare and Medicaid Services (CMS) program management that would restrict the agency’s ability to operate the Affordable Care Act programs, Medicare, and Medicaid.
- EDUCATION: Includes a $1.1 billion cut for the Department. However, the IDEA state grant program would receive a nearly 1% increase.
L-HHS – House – The House bill passed the full Appropriations Committee along party lines on June 24 and would provide discretionary funding at $3.7 billion below the FY 2015 level. The bill also includes numerous policy riders. The House bill included spending cuts and select increases similar to those in the Senate bill:
- LABOR: Includes a 2% cut for the Employment and Training Administration that helps to implement Workforce Innovation and Opportunity Act (WIOA) programs.
- HHS: Includes a $344 million cut for CMS.
- EDUCATION: Includes a cut of $2.8 billion to the Department of Education. However, this includes an increase of $12 billion (4.3%) for IDEA grants to states.
See the funding levels for specific disability related programs.
Last week, the Centers for Medicare & Medicaid Services (CMS) released Frequently Asked Questions (FAQs) related to Home and Community-Based Services (HCBS) Settings Rule. The guidance focuses on the process for states to use in overcoming the presumption that certain settings have the characteristics of an institution, and highlights the heightened scrutiny review that CMS will give such information submitted from states.
Last week, the Centers for Medicare & Medicaid Services (CMS) released a notice of proposed rulemaking toward modernization of the Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations and to update the programs’ rules and strengthen beneficiary services. For more information, including summaries of key provisions of the proposed rule, visit medicaid.gov. Staff from The Arc will be reviewing the regulations and providing comments. The deadline to submit comments is July 27, 2015.
Last week, the Centers for Medicare and Medicaid Services (CMS) released a report titled “The Right Supports at the Right Time: How Money Follows the Person (MFP) Programs Are Supporting Diverse Populations in the Community.” This report examines how six MFP grantees are serving populations with diverse needs in the community and the factors that have contributed to their performance on key outcome measures. The report is available here.
Last week, the deadline for states to submit their transition plans to CMS outlining how they will come into compliance with the HCBS Settings Rule passed. Several states have yet to submit their final plans; in fact some states are still collecting public comment in response to their proposals. CMS has not yet approved any of the transition plans which have been submitted for consideration. Federal resources and state by state details, including draft and final plans, can be found at www.hcbsadvocacy.org. The Arc will continue to monitor this issue.