Monday, December 9, 2013

Final CMS Rule on Medicaid Waiver Programs Expected in Late 2013 or Early 2014

By Dave Kyllo

Last week, Mark Parkinson, several NCAL/AHCA staff members and representatives from the National Association of States United for Aging and Disabilities (NASUAD), the Alzheimer’s Association (ALZ) and the National Association of Medicaid Directors (NAMD) met with representatives of the Office of Management and Budget (OMB) and the Administration to discuss the final CMS rule defining home and community-based settings under Medicaid waiver programs.  The final rule is currently at OMB for review before being published. 
NCAL/AHCA stressed the importance of keeping assisted living as an option for Medicaid waiver beneficiaries and said that several provisions in the last proposed version of the rule were troublesome and would displace a large number of Medicaid recipients.  The latest government statistics show that 19 percent of assisted living residents rely on Medicaid to pay for their services and 43 percent of assisted living communities nationwide have at least one Medicaid resident.  The other participating organizations, NAMD, AA, and NASUAD, also expressed notable concerns about the rule. 
Of particular concern are provisions related to proximity of an assisted living community to an institution such as a nursing facility, restrictions on locked units for residents with dementia and requirements that individuals be given the option of whether to share a room or demand an individual room. 
It is anticipated that the final rule will be published in late 2013 or early 2014. 

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