If you are a homecare agency, you should be aware of potential changes from Centers for Medicare and Medicaid Services that would require the payment of 80% of the Medicaid fees for services to the employees providing the services, defined as “… homemaker, home health aide, and personal care services on direct care worker compensation.”
Then, the other 20% would be for operating expenses, management team, etc. which might be difficult to comply for smaller players in the Homecare agency business.
The proposed rule was released on April 2024 and the final rule provided a six years period to implement, so potentially year 2030, the Homecare agency should comply for Medicaid fees (if private fees or payments, it should not be subject to these limitations). Note that these regulations will have to be implemented at the State level and there is some flexibility for exceptions and delays on certain cases.
We expect significant legal challenges in this area, but even if it is still early in the process, this topic has been discussed multiple times with clients in the Homecare industry. If you want to discuss further on this area, please, feel free to reach out to our team and this topic is a moving target of requirements, timelines and other factors.
Link CMS.gov – Centers for Medicare and Medicaid Services – Ensuring Access to Medicaid Services Final Rule (CMS-2442-F)
