CMS’ Daniel Tsai Stands Behind ‘80-20’ Provision, Medicaid Access Rule In Congressional Hearing

Home Health Care News / By Joyce Famakinwa
 
A senior Centers for Medicare & Medicaid Services (CMS) official stood behind the “80-20 rule” — which has drawn major pushback from the home-based care industry — during a congressional hearing Tuesday.
 
Last week, the “Ensuring Access to Medicaid Services” rule was finalized. The impetus behind the rule is to strengthen access to home- and community-based services (HCBS) for Medicaid beneficiaries.
 
The provision that has grabbed the most attention is the one that would require 80% of Medicaid payments for HCBS to be reserved for direct care workers’ wages.
 
During the hearing, House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) was critical of the 80-20 rule.
 
“The Medicaid access rule’s so-called 80-20 policy will lead to home care agencies reducing the amount of care that they can provide,” she said. 
 
Daniel Tsai – the deputy administrator and director of Center for Medicaid and CHIP services at CMS – defended the 80-20 provision, pointing to low wages in HCBS and the correlation to care quality, as he also did last week. 
 
“Data shows that direct care workers typically earn low wages and receive limited benefits, contributing to a shortage of direct care workers and high rates of turnover in this workforce, which can limit access to and impact the quality of HCBS,” he wrote in his witness testimony. “By supporting and stabilizing the direct care workforce, this provision will result in better qualified employees, lower turnover, and a higher quality of care, improving access to quality care for Medicaid beneficiaries.”
 
CMS wants to ensure that this percentage of Medicaid payments are going to direct care workers instead of things like administrative overhead or profit…

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