Medical Assistance -- Long-term Care Service And Finance Reform
Impact
If passed, the bill would represent a substantial shift in the state's approach to long-term care, focusing on enhancing the availability and quality of home- and community-based services. This effort is poised to significantly impact existing state laws regarding funding allocation and eligibility criteria, particularly for Medicaid services aimed at older populations and disabled individuals. The bill mandates annual reporting on the distribution of care types and the status of waiting lists, which aims to increase transparency and accountability within the Medicaid system. Moreover, it empowers the executive office of health and human services to prioritize investments in home- and community-based care and ensure continuity of existing services during the transition.
Summary
Senate Bill S2306 aims to reform and improve the long-term care service and finance structure within the state's Medicaid program. Introduced by Senator Walter S. Felag, the bill seeks to allocate a significant portion of Medicaid funding to home- and community-based care, specifically targeting the needs of individuals aged sixty-five (65) and older, as well as adults with disabilities. The bill emphasizes a commitment to rebalancing the long-term care system by creating options that prevent individuals from unnecessary institutionalization, thereby promoting independent living in community settings. It proposes amendments that would facilitate the development of regulations needed to implement these reforms effectively.
Contention
Despite its intended benefits, the reform initiatives outlined in S2306 are not without contention. Critics may express concerns regarding the funding mechanisms and potential impacts on institutional care providers whose services could be reduced as a result of the rebalancing efforts. There may also be apprehensions regarding the adequacy of resources for effectively managing the transition to more community-based care options, as well as the potential for increased eligibility criteria that may unintentionally restrict access to necessary services. Stakeholders, including advocacy groups for the elderly and individuals with disabilities, may engage in discussions to ensure that the reforms reflect the needs of these populations while maintaining protective measures against service discontinuity.
Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.
Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Raises the per diem rate by thirteen percent (13%) for Medicaid reimbursement for Tier C services provide by assisted living residence beginning January 1, 2026.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Prohibits contractors and subcontractors from paying employees the cash equivalent of any applicable healthcare benefit in lieu of actually purchasing the healthcare benefit unless the employee is covered under a different healthcare plan.
All Medicaid programs operated by EOHHS would not reimburse home care providers less than fee-for-service rates adopted by rate review recommendations of the office of health insurance commissioners.
Raises the per diem rate by thirteen percent (13%) for Medicaid reimbursement for Tier C services provide by assisted living residence beginning January 1, 2026.
Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.