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Rule would allow deductions from state Medicaid payments to pay for health insurance and other benefits on behalf of certain Medicaid practitioners
The Centers for Medicare & Medicaid Services (CMS) proposed a rule today which would enable states to make payments to third parties on behalf of certain individual health care practitioners, including home care workers and personal care assistants. These changes would make it easier for those workers to obtain and retain health insurance, training, and other employee benefits, fulfilling a key promise made by President Biden on the campaign trail to support home care workers. The rule, if finalized, would foster a stable and qualified health care workforce by making it easier for such practitioners to access benefits customary for full-time employees.
Today’s rule proposes to allow Medicaid state agencies to make deductions from Medicaid payments due to certain individual practitioners in order to make payment to third parties on behalf of those practitioners for typical employee benefits, if the practitioner has consented to such deductions. This rule would apply to the class of individual practitioners for whom Medicaid is their primary source of revenue. Many of these workers provide home and community-based services. These practitioners serve our most vulnerable individuals where they are enabling Medicaid beneficiaries to remain in their homes and communities. These changes would make it easier for these practitioners to enroll in, or pay for, customary employment benefits like health insurance and skills training. The rule would also help state Medicaid agencies by easing administrative burden, while providing additional flexibility to operate their programs more efficiently and effectively.
The Reassignment of Medicaid Provider Claims proposed rule comes in response to a 2020 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. Today’s proposed rule would reestablish this payment flexibility.
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.
To view the Proposed Rule, please visit: https://www.federalregister.gov/public-inspection/2021-16430/medicaid-program-reassignment-of-medicaid-provider-claims
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Contact: CMS Media Relations CMS Media Inquiries
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