Updates on Part AAAA Reimbursement and Section 9817 HCBS Bonus Payments
Maine Department of Health & Human Services sent this bulletin at 01/31/2022 10:31 PM EST
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Updates on Part AAAA Reimbursement and Section 9817 HCBS Bonus Payments
Part AAAA January 1, 2022 Rate Adjustments for Sections 12, 18, 19, 20, 21, 29, and 96:
The Maine Department of Health and Human Services (the Department) is increasing MaineCare reimbursement rates for many Home- and Community-Based Services (HCBS), effective January 1, 2022, pursuant to P.L. 2021, ch. 398, Part AAAA, An Act Making Unified Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2021, June 30, 2022 and June 30, 2023. As announced on December 30, 2021, these increases reflect additional funding sought by the Department to:
- update the cost-of-living adjustments (COLA) funded in the current biennial budget to reflect higher than anticipated inflation in 2021,
- accelerate the planned COLA from July 1, 2022 to January 1, 2022, and
- fully fund Part AAAA of the biennial budget to ensure that the labor components of rates are equal to at least 125 percent of minimum wage.
The Department is adopting rules and seeking approvals from the Centers for Medicare and Medicaid Services for the increased rates. In addition, the Governor’s proposed budget will ask the legislature for additional funds to support these increases.
The new rates for HCBS providers under Sections 12, 18, 19, 20, 21, 29, and 96 are linked here. The Department’s standard approach to these rate increases was to first apply a 4.9% cost of living adjustment to each rate, then to apply an additional increase, as necessary, to set the labor component of the rate equal to at least 125% of minimum wage.*
These rates will take effect retroactive to January 1, 2022; however, they are not yet in effect and are being provided for informational purposes only at this time. Please refer to the MaineCare e-message from January 7, 2022 for further discussion of these rate increases. The Department will notify providers and provide instructions when MaineCare has added the January 1, 2022 rates to the system for billing purposes.
For questions regarding these January 1, 2022 rate adjustments for Sections 12, 18, 19, 20, 21, 29, and 96, please contact MaineCare Provider Relations Specialist Tammy Usher.
*For exceptions to this standard approach, see the rate listing.
Part AAAA Monthly Supplemental Ramp Payments for Sections 2, 17, 26, 28 and 65:
In addition to the January 1, 2022 rate adjustments referenced above, the Department will also be issuing monthly supplemental “ramp” payments pursuant to Part AAAA of the biennial budget during calendar year 2022 for Sections 2, 17, 26, 28 and 65, effective in January 2022. Per Part AAAA of the budget, payment amounts will vary by provider: the Department will allocate the full amounts appropriated by the legislature for each section of policy to providers proportional to revenue they received for services under each section from October 1, 2020 to September 30, 2021. Supplemental payments per individual provider will be distributed in equal monthly payments for the months of January 2022 through December 2022 to providers of these services that provided services during the October 1, 2020 to September 30, 2021 date range. Total appropriated amounts by section of policy are listed below:
|
Section of Policy |
Total Supplemental Payment for Section to be Distributed Across Providers |
|
2-Adult Family Care Services |
$ 270,336 |
|
17-Community Support Services |
$ 1,298,423 |
|
26-Day Health Services |
$ 50,985 |
|
65-Behavioral Health |
$ 7,492,425 |
|
28-Rehab/Comm Supp for Children |
$ 471,240 |
The Department will conduct rate studies for these sections during calendar year 2022 to determine appropriate ongoing rate adjustments to be effective January 1, 2023 to ensure that the labor components of these rates are equal to at least 125 percent of minimum wage.
The Department is adopting rules and seeking approvals from the Centers for Medicare and Medicaid Services (CMS) for these payments. The monthly ramp payments will be effective retroactive to January 2022 and the Department will provide them as soon as possible; however, they are not yet in effect—this information is being provided for informational purposes only, at this time. Please refer to the MaineCare e-message from January 7, 2022 for further discussion of these supplemental ramp payments. The Department will notify providers and provide instructions when MaineCare is able to issue the supplemental ramp payments.
For questions regarding these supplemental ramp payments for Sections 2 and 26, please contact Provider Relations Specialist Tammy Usher; for Section 17, contact Amanda Lee; and for Sections 28 and 65, contact Danielle Sack.
Part AAAA January 1, 2022 Rate Adjustments and Supplemental Wage Add-On for Sections 67 and 97, Appendix C:
As Governor Mills announced on December 29, 2021, the Department will be implementing rate increases for Nursing Facilities and Residential Care Facilities (Private Non-Medical Institution, Appendix C) effective January 1, 2022 to:
- Assist these facilities to pay direct care workers at least 125 percent of minimum wage, in alignment with and utilizing $4.5 million in funding already appropriated under Part AAAA of the biennial budget, and
- Further assist nursing and residential care facilities with labor costs through the rest of the 2022 Fiscal Year through the reinstatement of a supplemental wage adjustment in the amount of $7.6 million. This add-on component of these rate adjustments is subject to legislative approval.
The Department is seeking certain approvals from the Centers for Medicare and Medicaid Services (CMS) for these rate increases.
The Department is incorporating these increases into its regular January rate letters to these facilities—as a result, the Department plans to issue these letters in February, in order to ensure facility rate letters are inclusive of all rate changes. These rates will take effect retroactive to January 1, 2022; however, they are not yet in effect are being provided for informational purposes only at this time.
For questions regarding these fiscal year 2022 Nursing Facility and Residential Care Facility rate adjustments, please contact Peter Kraut.
Update on Section 9817 HCBS Bonus Payments:
On January 26, 2022, MaineCare received Federal approval of its Disaster State Plan Amendment (D-SPA), the third and final Federal approval needed to make bonus payments to providers under Section 9817. With the Office of Aging and Disability Services (OADS), it is finalizing logistics and expects payments to be issued in February. Details are forthcoming.