WASHINGTON--CMS is seeking input on a proposed rule that would allow Medicaid beneficiaries to take charge of their own personal assistance services.
If finalized, the rule would allow Medicaid beneficiaries needing help with activities of daily living to hire, direct, train or fire their own personal assistance care workers. Under the proposal, beneficiaries could even hire qualified family members to perform the caregiver tasks.
"This proposal would give Medicaid beneficiaries significant new freedom to determine how their personal assistance services are delivered and by whom," said Kerry Weems, CMS acting administrator. "As health care is not simply an economic transaction, this proposal represents a fundamental shift that restores a person's ability to improve their overall health by taking greater control of his or her own decisions."
The proposal would put into place a provision of the Deficit Reduction Act of 2005 that allows states to elect a plan option to provide care in ways that previously required waivers of Medicaid rules.
If a state adopts such an option, beneficiaries could receive a cash allowance to hire workers to help with bathing, preparing meals, household chores and related services. Allotments could also be used to purchase items that help foster independence, like wheelchair ramps or microwave ovens.
According to CMS, two national demonstration projects conducted in the 1990s showed the success of personal assistance services programs. If implemented, the program is estimated to cost $225 million between 2008 and 2012. Of that, the federal share would be $127 million, CMS said.
Notice of the proposed rule was published Jan. 18 in the Federal Register. Comments on the proposal are due Feb. 19.
