More on the Hill & Industry Insiders Voice Disappointment in Medicaid Access Rule

Since the Centers for Medicare & Medicaid Services (CMS) released its Final Rule on “Ensuring Access to Medicaid Services” on Monday, April 22, many in the industry have voiced their disappointment in the rule, including the National Association for Home Care & Hospice (NAHC), who called it a “misguided policy” that will add more pressure to already stressed staffing in home- and community-based care.

The new rule institutes minimum staffing requirements at skilled nursing facilities (SNFs), and a new requirement for home- and community-based service (HCBS) providers that directs 80% of Medicaid payments to be spent on wages for aides and nurses

Recently, Lutheran Services in America, a nonprofit provider network of services for older adults in the United States, joined those expressing their concern regarding the rule.

“We strongly urge the administration to reconsider implementing these rules without further changes to address workforce shortages and adequate reimbursement rates,” said Lutheran Services in America President and CEO Alesia Frerichs. “We share the administration’s goals of quality skilled nursing homecare along with greater access to home- and community-based services (HCBS)…These rules simply do not reflect or address realities in communities across the country—especially in rural and underserved areas. With Medicaid reimbursement unable to keep up with current costs and challenges with workforce recruitment, these rules will only force high quality nonprofit providers to close their doors—further constraining access to care.

Additionally, those on Capitol Hill have also said the rule will only put further stress on those seeking to provider care to the senior population. 

House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) released the following statement after the Biden administration announced its final Minimum Staffing Rule and Medicaid Access Rule:

“The President’s one-size-fits-all, Washington-knows-best approach to long-term care is an unfunded mandate that will drive up costs and threaten access for patients,” Rodgers said. “The minimum staff-to-patient ratio is unworkable for nearly 80% of nursing homes, requiring facilities to increase costs for patients or close their doors to new patients. The so-called ‘access rule’ creates untenable standards for home health agencies to meet. Both rules in practice will result in reduced access to care for those that need it most and their families.”

Another Chairman, House Ways and Means Committee Chairman Jason Smith (MO-08), called the mandate a “disaster”. 

“Seniors could lose access to 280,000 nursing home beds, forcing older Americans to pick up and move to nursing homes far from friends and family, if they are lucky enough to find an open spot,” Smith said. “Nursing homes are not suffering from a lack of mandates. They’re facing a lack of nurses. This rule would only make things worse for our seniors and the health care providers who support them. 

“Over 1,000 nursing home groups have spoken out against this overreaching regulation, yet the Biden Administration is again choosing to ignore the American people in favor of bigger and more intrusive government. The Ways and Means Committee has passed bipartisan legislation to block the implementation and enforcement of this staffing mandate. We will continue to fight for quality care for American seniors in every single community.”