BIRMINGHM, Ala. (May 13, 2022)—Medicaid can directly pay for independent home health aides' benefits, including health insurance and skills training, according to a final rule the Centers for Medicare & Medicaid Services (CMS) issued Thursday. The final rule allows State Medicaid agencies to provide home health aides not working with an agency employee benefit premiums and union dues deducted from their paychecks. 

The final rule fulfills a key promise made by President Biden on the campaign trail to support homecare workers and bolster home and community-based services (HCBS), CMS said in a press release. 

“We recognize that HCBS workforce issues, such as workforce shortages and staff turnover, have a direct and immediate impact on the quality of and access to services available to beneficiaries,” the rule reads, in part.

CMS initially proposed the rule in July 2021. State Medicaid agencies would be able to take deductions from independent contractor reimbursement to provide benefits. The practitioner must consent to the deductions. The rule should also ease state Medicaid agencies’ administrative burdens 

Flexibility is at the core of this rule. State agencies not seeking to make these third-party payments on behalf of individual practitioners would not face any new administrative burden.

The Reassignment of Medicaid Provider Claims proposed rule was in response to a 2020 the United States district court ruling that vacated a 2019 final rule. The 2019 rule prohibited states from making these types of payments to third parties. This rule reestablishes this payment flexibility. 

“We strongly support the proposed amendments because they will ensure that homecare workers can continue to make deductions for health, training, and other standard workplace benefits, which is key to enabling the self-directed model for delivery of HCBS,” said Justice in Aging in comments in support of the proposed rule. The organization opposed the 2019 rule.

Find the full text here.