ANCOR Issues Statement in Response to CMS’ Final Access Rule

In response to the Centers for Medicare & Medicaid Services’ (CMS) final Access Rule, published earlier this week after having been proposed in April 2023, ANCOR CEO Barbara Merrill released the following statement:

“Medicaid-funded community service providers, including those represented by ANCOR that provide habilitation services to people with intellectual and developmental disabilities (I/DD), have long faced a dire workforce shortage due to insufficient Medicaid reimbursement rates. As countless ANCOR members affirmed in their comments to CMS, increased wages would help attract and retain desperately needed direct support professionals, but they have been, and will continue to be, hamstrung by Medicaid when it comes to what they can afford to pay. Community service providers are unable to raise wages on their own unless their state increases Medicaid reimbursement rates for them or the federal government increases its match to states’ Medicaid spending.

ANCOR appreciates that CMS has listened to our concerns and not taken the drastic step of imposing a rigid policy limiting how I/DD providers can spend payments from Medicaid. Habilitation services require adaptable funding in order to meet the differing needs of people with I/DD, so that they can be successfully included and integrated in their communities. We are grateful that states will retain the flexibility to utilize programmatic funding in ways that best reflect the unique characteristics and needs of different communities and people. Rigid requirements like a mandated 80% payment adequacy threshold for I/DD services could have had a negative impact on access, forcing providers to cut programmatic and overhead costs, leading to additional closures, decreased availability of direct care worker positions, and diminished access to services.

We applaud the provisions of the final rule that improve transparency of payment rates and rate setting, metrics related to waiting lists and quality measures, and a foundation of incident management systems to improve critical incident reporting.

ANCOR appreciates CMS’s recognition of the acute impact the direct support workforce crisis is having on I/DD services, and while the transparency- and data-related provisions of this rule do not solve the root cause of the workforce crisis crisis, they represent another indication from CMS of its eagerness to strengthen the care economy. Insufficient Medicaid payment rates that do not include adequate funding for competitive workers wages continue to plague care services of all kinds, and ANCOR remains steadfast in partnering with lawmakers in the administration and in Congress to sufficiently fund home- and community-based services for everyone who needs them.”