The Connecticut Department of Social Services (DSS) has been hosting several stakeholder meetings to elicit information regarding the current Medicaid services in the state of Connecticut. Meetings have been held virtually to glean information from the perspective of the consumers, providers and advocates.  

 

Questions include: What’s going well and not so well; What are some suggestions for improvements; and Are there any other state models that might be helpful here in CT?

 

Several of our Association provider members, along with Pres/CEO Tracy Wodatch, participated in a call last Thursday.  

 

Feedback included the following:

As the state looks to improve Medicaid services with a strong focus on cost-effective access to care, they have been asked by the governor to, once again, review other options such as Managed Medicaid.  Stakeholders on the calls have been expressly vocal as to the poor experiences and services in the past under Managed Medicaid and offer limited to no support for this model.   

Source: The Alliance, November 7, 2024

 

The National Alliance for Care at Home (the Alliance) has endorsed H.R. 10097, the Enhancing Hospice Oversight and Transparency Act, introduced in the House of Representatives. The Alliance supports delaying the implementation of the Centers for Medicare & Medicaid Service’s (CMS) hospice Special Focus Program (SFP), to allow for additional time to correct its flawed design that creates a high risk of failing to identify poor performing hospices that should be subject to increased oversight.

The SFP was created under the HOSPICE Act, which established additional tools for CMS to oversee the Medicare Hospice Benefit. Notably, Representative Panetta —the original architect of the bill—has teamed up with Representative Van Duyne to decisively address and correct CMS’ flawed implementation of the program, ensuring it fulfills its original intent.

Source: The Alliance, November 8, 2024

The Centers for Medicare & Medicaid Services (CMS) hosted the Home Health, Hospice, and DME Open Door Forum call on November 7, 2024, and covered several topics related to home health and hospice providers.

The rule finalizes a permanent adjustment of -1.975% (half of the calculated permanent adjustment of -3.95%) to the CY 2025 home health payment rate to account for the impact of implementing the Patient-Driven Groupings Model (PDGM). For CY 2023 and CY 2024, CMS previously applied a 3.925% reduction and a 2.890% reduction, respectively, which were half of the estimated required permanent adjustments.

While CMS did not propose to implement a temporary behavior adjustment in 2025, the final rule provided the calculated temporary behavior adjustment dollar amount, which is approximated to be $971 million based on the calendar year 2023 claims.

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Source: McKnight's Home Care, October 25, 2024

 

Source: Home Health Care News, October 31, 2024

 

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