Capitol Correspondence - 05.07.24

House Subcommittee Holds Hearing on Medicaid Access and Integrity Proposals

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The House Energy and Commerce (E&C) Subcommittee on Health recently convened a hearing to deliberate on 19 legislative proposals aimed at enhancing beneficiary access to Medicaid services and bolstering the integrity of the Medicaid program. The discussion largely centered on the implementation of two key rules finalized by the Centers for Medicare and Medicaid Services (CMS): the Minimum Staffing Standards for Long-Term Care Facilities (Minimum Staffing) and the Ensuring Access to Medicaid Services (Ensuring Access) rules. Daniel Tsai, Deputy Administrator and Director of the Center for Medicaid and CHIP Services at CMS was the sole witness for the hearing.

Democrats expressed support for the finalization of the rules, emphasizing their potential to improve access to long-term care and home and community-based (HCBS) services. Conversely, several Republican members of the Subcommittee advocated for two bills that would block the implementation of these final rules: the Protecting America’s Seniors Access to Care Act (H.R. 7513) and H.R. 8114, which would block CMS from finalizing portions of the Access Rule.

One point of contention among Subcommittee members was the provision in the Medicaid Ensuring Access rule requiring home care providers to allocate 80 percent of Medicaid payments toward direct care worker compensation (the “80/20 Rule”). Republicans raised concerns about potential negative impacts on beneficiary care, while Democrats defended the rule, asserting that it would strengthen supports for the direct care workforce and improve beneficiary access to care.

Despite differing perspectives on certain aspects of the rules, Subcommittee members unanimously acknowledged the importance of reducing instances of improper payments in Medicaid. They urged for the passage of several bills aimed at mitigating improper payments and combating fraud, waste, and abuse within the Medicaid program.