Capitol Correspondence - 08.03.21

CMS Proposes Rule to Reinterpret the Scope of Medicaid State Payments

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The Centers for Medicare & Medicaid Services (CMS) proposed a new rule, Reassignment of Medicaid Provider Claims, which would authorize states to make payments to third parties to benefit individual practitioners.

The proposed rule would give states flexibility to make deductions from Medicaid payments to individual practitioners to make payment to third parties for customary employee benefits, including health and welfare benefits. In the news release and regulatory rationale, CMS highlights this may support and strengthen stabilization of the home and community-based services workforce. More specifically that states may be able to use existing administrative processes for their own employees to simplify administrative functions and program operations which advantage individual practitioners.

Currently, it appears the language is limited to individuals providing services independent of agencies (e.g. self-directed services).

News release here: CMS Proposes Rule to Support Home Care Workers Access to Benefits | CMS

Full text here: Federal Register

Written comments can be made by September 28, 2021 electronically at under the “submit a comment” tab or by regular mail to the Department of Health and Human Services, Attn: CMS-2444-P, P.O. Box 8016, Baltimore MD 21244-8016.

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