The Centers for Medicare and Medicaid Services (CMS) will be hosting a webinar on engaging stakeholders in rate-setting on May 8 at 1:30pm ET. ANCOR is sharing this announcement because Medicaid rate-setting is at the heart of many challenges faced by people with disabilities and the organizations that support them with their daily lives, not the least of which is a severe workforce shortage. The majority of supports for people with disabilities are supported by Medicaid.
As shared by CMS:
Engaging Stakeholders in the Rate Setting Process
Wednesday, May 8, 2019 at 1:30pm – 3:00pm ET
Stakeholder engagement during the rate-setting process is a critical component for approval of the 1915(c) waiver application. This process allows the state to ensure all concerned parties have an opportunity to provide their input in updating or determining rate methodologies. In this session, CMS will provide promising practice examples for engaging stakeholders (e.g., individuals, family members, advocates, providers, operating agency, State Medicaid Agency, legislators, etc.) in the rate-setting process. Lewis & Ellis is currently the training lead through the Rate Review Multi-Award Contract overseen by the Division of Long Term Services & Supports (DLTSS). Lewis & Ellis will present the training and Ralph Lollar, DLTSS Division Director, and the DLTSS Team will support the training and lead the Q&A Session.
Primer for those less familiar with Medicaid: Medicaid is a federal-state partnership, meaning state legislatures decide how much to invest in their Medicaid programs and the federal government matches their spending, leading to different Medicaid programs from state to state. Rate-setting is the process by which state Medicaid agencies take the funding given to them by their legislatures and allocate it to their programs. Because many policy-makers often confuse Medicaid processes with Medicare processes, it is important to note that in Medicaid funding rates are fixed and providers cannot negotiate them. This is in contrast to Medicare, where providers bill their costs to the program and receive reimbursement. In Medicaid, the fixed rates might not cover the full cost of a support or service. In fact, in many states rates have not changed for years even in the face of inflation, putting pressure on disability supports which are in high demand, to the point that there are waiting lists for these supports.