Health and Disability

from Medical news Today: 


A final rule that would allow more Medicaid beneficiaries to be in charge of their own personal assistance services, including personal care services, instead of having those services directed by an agency, was announced by the Centers for Medicare & Medicaid Services (CMS).

The rule, on display today at the Federal Register, guides states who wish to allow Medicaid beneficiaries who need help with the activities of daily living to hire, direct, train or fire their own personal care workers. Beneficiaries could even hire qualified family members who may already be familiar with the individual's needs to perform personal assistance (not medical) services.



http://www.cms.hhs.gov/

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

CMS officials this week announced a regulation that places a three-year moratorium on the construction of new long-term care hospitals and limits the effects of payment reductions to existing facilities, CQ HealthBeat reports. According to CQ HealthBeat, admissions criteria among long-term care hospitals and the industry’s “Medicare-fueled growth” had “raised eyebrows among policy makers.”

As a result, several regulatory provisions, including a proposal to reduce base rates and the extension of the so-called 25% rule, were “putting the hurt” on the long-term care hospital industry. The 25% rule reduced payments for care of each patient from a single referring facility above one-quarter of a long-term care hospital’s patient load. According to CQ HealthBeat, the 25% rule addressed hospitals building long-term care facilities within their own facilities to capture higher revenues associated with long-term care. The new regulation implements provisions of a measure signed by President Bush last year regarding Medicare and Medicaid payments and an extension of SCHIP.

The new revisions “ease the impact” of the 25% rule and block the base rate reduction, according to CQ HealthBeat. In addition, the regulation sets policies for implementing the moratorium and determines which facilities will be prohibited from new construction. CMS will be evaluating exemptions on a case-by-case basis, according to Alec Vachon, a Washington, D.C. consultant and former Senate Finance Committee staffer. The regulation will be published in the Federal Register on Thursday (Reichard, CQ HealthBeat, 5/21).

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Two new proposed rules that would give states unprecedented flexibility in designing their own Medicaid programs, including adjusting their benefit package to more closely align with beneficiary needs and requiring increased cost sharing by enrollees, were announced by the Centers for Medicare and Medicaid Services (CMS).

The proposed rules would implement provisions of the Deficit Reduction Act of 2005 and the Tax Relief and Health Care Act of 2006. The rules are the latest in a series of regulations to implement the Administration's goals of aligning Medicaid more closely with private market insurance and giving states more control over their Medicaid benefits packages.

The Centers for Medicare & Medicaid Services (CMS) recently announced that it will hold the next Skilled Nursing Facility/Long-Term Care Open Door Forum at 3:30 p.m. (EST) on February 27, 2008.

To participate by telephone, one must dial 1-800-837-1935 and reference conference ID 18796437. To participate in person, one must RSVP by 2:00 p.m. (EST) on February 25, 2008 to SNF_LTCODF-L@cms.hhs.gov, and include your name, organization, phone number, and “SNF/LTC” in the subject line. The Open Door Forum will take place at the Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington, D.C. CMS asks that attendees arrive no later than 3:00 p.m. (EST).

MS on Monday announced it will accept public comment on a proposal to provide some Medicaid beneficiaries with a cash allowance to hire personal care workers, CQ HealthBeat reports. If their home states elect to adopt a self-directed personal assistance services option in their state plan, beneficiaries would be able to hire and train their own qualified caregiver -- who could be a family member -- to assist with daily activities but not direct medical care.