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The Centers for Medicare and Medicaid Services (CMS) published an interim final rule with comment period (IFC) in the May 13, 2021 Federal Register that revises the infection control requirements that long-term care (LTC) facilities and intermediate care facilities for individuals with intellectual disabilities must meet to participate in the Medicare and Medicaid programs. The goal of this IFC is to reduce the spread of COVID-19 by requiring education about COVID-19 vaccines for LTC facility residents, ICF-IID clients, and staff serving both populations, and by requiring that such vaccines, when available, be offered to all residents, clients, and staff. It also requires LTC facilities to report COVID-19 vaccination status of residents and staff to the Centers for Disease Control and Prevention (CDC). These requirements are necessary to help protect the health and safety of ICF-IID clients and LTC facility residents. In addition, the rule solicits public comments on the potential application of these or other requirements to other congregate living settings over which CMS has regulatory or other oversight authority. The regulations are effective on May 21, 2021; however, comments will be accepted but must be submitted by 5:00 pm on July 12, 2021 to be assured for consideration.
The Employment First Community of Practice webinar on “Value, Outcome and Performance-Based Payment Methodologies to Advance Competitive Integrated Employment in State Medicaid Long-Term Services and Supports (LTSS) Systems and Managed Care LTSS Systems” is available for viewing in the archives. The webinar presents examples of state Medicaid LTSS systems, some that are using managed care and some that are not, that have designed and implemented value-based purchasing and outcome-based reimbursement methods to advance Employment First and Competitive Integrated Employment.
Visit here to view “Value, Outcome and Performance-Based Payment Methodologies to Advance Competitive Integrated Employment in State Medicaid Long-Term Services and Supports (LTSS) Systems and Managed Care LTSS Systems.”
From ANCOR:
Happy Friday, ANCOR Members! Two months after President Biden signed the American Rescue Plan into law, CMS finally released its guidance to states on the 10% FMAP bump dedicated to HCBS. We are still analyzing it carefully, but initially it appears that stakeholder input was carefully considered. Of immediate significance:
Below is an overall summary of the full guidance:
Since the beginning of the pandemic, ANCOR alongside our disability partners has worked tirelessly to address those needs – finding new ways to deliver services and increase capacity, ensuring the needs of people with disabilities have been considered at every step of the COVID-19 response, and ensuring that the magnitude of the needs are understood.
As a result of that advocacy, the American Rescue Plan Act of 2021 (ARP) included several provisions to help address these unmet needs. One of them is a temporary, but significant, increase in federal funding for home and community-based services (HCBS). Specifically, states can receive a 10 percentage-point increase to the federal medical assistance percentage (FMAP) they receive for certain Medicaid expenditures for HCBS. This “FMAP bump” is available for one year, from April 1, 2021 to March 31, 2022.
In a letter to State Medicaid Directors issued Thursday, the Centers for Medicare & Medicaid Services (CMS) provided states with guidance for receiving the funding. The letter provides more precise details, but services and activities can be provided through a variety of different Medicaid HCBS programs, and a wide variety of services and supports that both older adults and people with disabilities rely upon are eligible. For example, states can claim additional federal funds for:
Additional funding also can be used for a range of activities that help increase community living options. The following are just a few of the many examples described in CMS’ letter:
(Note that services paid for through administrative match, such as those offered through the Long-Term Care Ombudsman program and certain No Wrong Door program activities, are not eligible.)
An important condition for receiving this funding is that states cannot decrease their own funding of HBCS. In other words, states cannot use the additional federal funding instead of state funds; the funds must be used in addition to the state’s own investments. They also may not cut HCBS services during this time. That means states may not eliminate covered services or reduce the amount, duration or scope of those services. In addition, they may not impose stricter eligibility requirements for HCBS programs and services than were in place on April 1, 2021 or reduce provider payments.
***States can contact HCBSincreasedFMAP@cms.hhs.gov if they have questions about the services which can claim the increased FMAP.
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Shannon McCracken
Vice President of Government Relations
ANCOR
606-271-3555
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The Senate Aging and Youth Committee has announced an upcoming public hearing on Thursday, May 20, 2021 at 11:00 am. This public hearing will focus on the current status and needs of long-term care facilities one year after COVID-19. This hearing will be live streamed and will also be archived for future viewing.
The Centers for Medicare & Medicaid Services’ (CMS) accelerated payment program provides necessary funds when there are disruptions in claims submission and/or processing. The Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116–136) expanded the program to include not only acute care hospitals, but also children’s hospitals, certain cancer hospitals, and critical access hospitals. CMS further expanded eligibility for accelerated/advance payments during the COVID-19 public health emergency (PHE) to all Medicare providers and suppliers.
On April 1, 2021, CMS issued a notice “Repayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021” for all Medicare providers and suppliers who requested and received COVID-19 Accelerated and Advance Payments (CAAPs) from CMS due to the COVID-19 PHE. It notifies providers that CMS began recovering the CAAP payments as early as March 30, 2021 (depending upon the one-year anniversary of when a provider received their first payment). The notice also provides information on how to identify recovered payments. Some highlights from the article include:
The accelerated payments provided a critical lifeline to health systems during this PHE. The requirement to repay these funds could place health systems in financial distress while trying to recover from the pandemic. RCPA is requesting feedback from members on the impact of the accelerated payment relief plan. Please take a few minutes and respond to the following questions:
Please send your responses to Melissa Dehoff by Wednesday, May 26, 2021.