Indiana Medicaid now requires providers of attendant care and family caregiver services to directly pass a specific portion of Medicaid funds to frontline caregivers, similar to the 80/20 rule, and could inspire other states to do the same. This change, aligning with federal standards, took effect on July 1, and agencies must confirm compliance by […] The post Indiana Adopts New Caregiver Pay Standards, Setting Possible Example For Other States appeared first on Home Health Care News.
Indiana Medicaid now requires providers of attendant care and family caregiver services to directly pass a specific portion of Medicaid funds to frontline caregivers, similar to the 80/20 rule, and could inspire other states to do the same.
This change, aligning with federal standards, took effect on July 1, and agencies must confirm compliance by July 24. Many providers are concerned that Indiana’s implementation of this rule will lead other states to follow suit, according to Angelo Spinola, home health, home care and hospice chair at Polsinelli law firm.
“Many states are concerned with shortages in the home care workforce, and direct caregiver passthrough requirements are one way to try and address this issue, so it would not be shocking to see other states attempt a similar strategy, particularly if the federal rules are rescinded,” Spinola told Home Health Care News.
For health and wellness, traumatic brain injury and Indiana PathWays for Aging 1915(c) waivers, the minimum percentage passthrough for attendant care services will be 70% and the minimum percentage passthrough for structured family caregiving services will be 60%, according to an Indiana Family and Social Services Administration (FSSA) policy brief.
Like the CMS 80/20 rule finalized under the Biden administration, the FSSA Office of Medicaid Policy and Planning mandates providers to detail how Medicaid funds are allocated to frontline caregivers, covering wages, benefits and related expenses. Providers are required to maintain records supporting their compliance with these requirements and be prepared to face an FSSA audit.
However, these requirements are independent of the current federal 80/20 rule and require independent compliance, according to Spinola. As such, the Indiana requirement would need to be independently challenged for it to be repealed.
“Importantly, the federal 80/20 rule is not currently in effect and there is a distinct possibility that it will be repealed before ever going into effect,” Spinola explained. “If the 80/20 rule does go into effect unmodified, then there are likely to be conflicts between federal and state standards that will raise meaningful preemption questions.”
Providers affected by these requirements should review their internal compensation and accounting records to ensure they comply with FSSA’s passthrough standards. They should also develop policies to support compliance in the future, consult with legal counsel about how these requirements may impact their organization and monitor the implementation of the federal 80/20 rule, according to Polsinelli.
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