The May 11 over of the COVID-19 public health emergency — & the flexibilities it provided — means many potential changes for providers of Medicaid home- và community-based services. And those changes are worrying senior living industry advocates.
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Jeanne McGlynn Delgavì, vice president of government affairs for the American Seniors Housing Association, told McKnight’s Senior Living that ASHA is concerned about several changes tied lớn the ending of the PHE that will affect senior living, including cost-sharing on COVID-19 testing & treatments for most individuals, and states beginning Medicaid redeterminations.
Between 5 million và 14 million current Medicaid beneficiaries are expected to lớn no longer be eligible, which may affect coverage of services provided by assisted living communities under HCBS waivers, Delgavày said.
“States were also provided a 6.2% FMAP
The federal government last fall issued a compliance warning khổng lồ HCBS providers khổng lồ make progress on meeting the requirements of the HCBS settings final rule that goes into lớn effect in the spring. States that thought they would be unable lớn meet the March 2023 deadline had until Jan. 1 to submit statewide transition plans documenting their efforts to lớn adopt new regulations, conduct provider compliance assessments and establish processes for beneficiaries lớn report provider noncompliance.
HCBS waitlists total around 700,000 people nationwide, & more than 80% of providers are turning away new referrals due to limited staff capathành phố, Inside Health Policy reports.
LaShuan Bethea, executive sầu director of the National Center for Assisted Living, told McKnight’s Senior Living that assisted living providers have remained committed lớn delivering the highest chất lượng of care throughout the pandemic.
“There is still more work khổng lồ vì khổng lồ address challenges spurred by the pandemic, including a historic labor và economic crisis,” she said. “We will continue lớn work toward effective solutions that will help us rebuild and allow us lớn continue investing in and serving seniors in a meaningful way.”
Some changes will remain
The US Department of Health & Human Services & its Centers for Medicare và Medicaid hosted an informational Điện thoại tư vấn Monday to lớn address what will and won’t be affected by the ending of the COVID-19 PHE.
In a letter last week to governors, HHS Secretary Xavier Becerra told governors that the PHE would end May 11, following a similar proclamation from President Biden. HHS also provided a roadmaps detailing the transition.
“The nation is in a better place,” Steven Cha, counselor to lớn the HHS Secretary, said on Monday’s Điện thoại tư vấn. “Over the last two years, the administration implemented the largest adult vaccination program in US history.”
Although some Medicaid waivers & flexibilities will sunmix with the over of the COVID-19 PHE, others will remain in place, including major telehealth flexibilities for those participating in Medicaid or Medicare, access khổng lồ COVID-19 vaccinations và treatments, và emergency use authorization for COVID-19 tests, treatments và vaccines.
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Hannah Katch, senior adviser to the CMS Office of the Administrator, said that for community-based organizations, flexibilities related to lớn how and where Medicaid enrollees receive care will be available after the PHE if states choose to lớn continue them. Beginning April 1, states can begin removing individuals from the Medicaid program if they no longer are eligible for coverage.
Argentum is looking at the Axinh đẹp Hospital Care at trang chủ Medicare waiver that gives hospitals flexibility from Medicare conditions of participation to lớn receive sầu payment for care provided for adễ thương conditions in the trang chủ. CMS has noted that “many existing Ađáng yêu Hospital Care at trang chủ programs provide
Actions in one setting affect all others
But another area of concern, ASHA’s Delgavì chưng said, are now-expired waivers and flexibilities that had been offered under the PHE khổng lồ the skilled nursing industry lớn cover additional nursing staff. The loss of those workers, she said, will have sầu a “domino effect on the broader long-term care industry,” including senior living, which is “struggling to find chất lượng, compassionate workers to serve our residents.”
“The federal government, the agencies and Congress should recognize the challenges of staffing for all long-term care settings và seek opportunities to grow this workforce và not take steps khổng lồ undermine this fragile industry at this time,” Delgado said, adding that ASHA is advocating for immigration resize lớn meet the growing demand for workers.
HHS pledges a smooth transition
Since the peak of the omicron variant surge at the kết thúc of January 2022, Cha said, daily COVID-19 cases are down 92%, deaths are down by more than 80% and new COVID-19 hospitalizations are down more than 80%.
“We are not done,” Cha said. “Addressing COVID-19 remains a significant public health priority for this administration.”
What won’t change, he said, is access to lớn COVID-19 vaccines, treatments & testing. The federal government pledged khổng lồ work with stakeholders lớn ensure a smooth transition, particularly for older adults & individuals with disabilities. Medicare and Medicaid enrollees will continue lớn have access lớn không lấy phí vaccines, tests and treatments through September 2024.
Centers for Disease Control and Prevention reporting on community levels of COVID-19 — which insize recommendations related to lớn masking và social distancing — also will not change. Community levels are based on the number of COVID-19 admissions lớn hospitals & the number of COVID-19 positive tests, & that definition will not change, Cha said.
What the government will lose is lab reporting on negative tests, he said. At the over of the PHE, HHS no longer will have sầu express authority khổng lồ require lab kiểm tra reporting. The CDC, however, has been working on securing voluntary agreements with states and jurisdictions lớn continue to giới thiệu vaccine administration data.
Court orders reinstatement of benefits
Meanwhile, a federal district court judge in Connecticut issued a nationwide preliminary injunction recently in a pending case against HHS, ordering the federal government to lớn stop enforcing an illegal interlặng final rule that stripped Medicaid benefits from hundreds of thousands of older adults and people with disabilities.
A lawsuit alleges that the interlặng final rule, put in place in November 20đôi mươi under the Trump administration, violates the Families First Coronavirus Response Act by requiring states lớn reduce Medicaid rolls. The rule created several exceptions lớn the continuous coverage requirement.
The preliminary injunction is in effect until March 31 và requires HHS to reinstate anyone wrongly terminated from Medicaid, retroactive sầu to the date of termination.
