The bill amends Section 40-8.9-9 of the General Laws to establish a long-term-care rebalancing system reform goal. It requires that all Medicaid programs operated by the executive office of health and human services, its subordinate agencies, contractors, and all commercial lines within health insurance companies contracted with the Medicaid program shall not reimburse home care providers, home nursing care providers, and hospice providers less than fee-for-service rates. The executive office of health and human services is responsible for applying for necessary waivers and amendments to implement this plan, which includes annual reporting on funding distribution between institutional and community care, as well as service waiting lists.
The bill emphasizes a person-centered approach that promotes individual choice and self-determination, ensuring access to a variety of supportive services in community settings. It introduces provisions to enhance the capacity and quality of home- and community-based services, including the consolidation of existing services, establishment of service eligibility criteria, and development of payment methodologies to improve access to care. It mandates the implementation of a long-term-care-options counseling program and a conflict-free case management network to assist individuals in navigating their care options.
Additionally, the bill includes provisions for increasing wages for home-care workers and ensuring that Medicaid reimbursement rates for home care providers meet or exceed fee-for-service rates. It sets Medicaid fee-for-service reimbursement rates as the minimum for Medicaid managed care provided by home care, home nursing care, and hospice providers, while continuing the behavioral health training program and rate enhancements for licensed nurse assistants and homemakers delivering paraprofessional care services to Medicaid home care beneficiaries. The act will take effect upon passage.
Statutes affected: 255: 40-8.9-9