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07/20/2023
Medicaid on HCBS: “80 percent” Increase to AL Waiver, Rates Effective January 1
In a series of webinars with stakeholder groups, the Ohio Department of Medicaid (ODM) highlighted its plans for implementing provider rate increases included in the SFY 2024-2025 biennial budget. ODM committed to providing the same transparency into the various rules, waiver amendment and state plan amendments (SPA) necessary before the rates can be implemented. Additionally, ODM shared that it was prioritizing two policy areas above others in its amendment applications to the Centers for Medicare & Medicaid Services:
- Rate increases for providers to alleviate the extraordinary wage pressure experienced across settings, and
- Changes needed to implement the paid family caregiver rule ahead of the November 12 expiration of the Appendix K waiver.
ODM cautioned that the estimates shared were “orders of magnitude” and that it had yet to settle on exact reimbursement levels. For example, a wide class of home- and community-based services were estimated to see increases of 40%, but that will certainly vary widely, since personal care aide and homemaker services were slated to rise to a rate supporting a $18 / hour wage, while other services like home-delivered meals and adult day would see smaller increases. Noteworthy was the assisted living waiver, which will have a new two-tier structure reflecting a base rate and memory care add-on, would see funding increase by 80% over its current level.
ODM shared that with few exceptions, rates are planned to take effect January 1, 2024. To review the slides and tracker tool developed by ODM, click here.