New Medicaid Rules can Have an Impact on Your Estate Planning- Navigating long-term care is never easy. Recent changes in Medicaid rules demand your attention. The latest Medicaid rule, also known as the "80/20 rule," aims to improve access to care and transparency. Some believe that controversial new regulations could decrease access to care. Here’s what families and seniors need to know.
The Centers for Medicare and Medicaid Services (CMS) released a landmark rule on April 22, 2024, the "Ensuring Access to Medicaid Services Final Rule." It sets new standards for payments, care quality and transparency. The most controversial provision is the 80% compensation pass-through requirement for direct care workers.
The 80/20 rule mandates that providers pass on 80% of Medicaid rates to direct care workers for three specific services:
The rule strengthens person-centered service planning by providing annual functional assessments to 90% of Medicaid enrollees. States must now use advisory groups that include Medicaid participants when developing rates. Providers must also publish rates, report cost structures and disclose percentages for bundled services. While this is a positive change, it requires extra resources to implement.
Although the rule intends to improve care access and quality, many providers may struggle to comply with the 80/20 rule due to financial constraints. According to LeadingAge, this could reduce the number of Medicaid providers available to seniors and increase prices.
Providers must report compliance with the 80/20 rule at the individual provider level rather than at the state level. This means more paperwork and potential penalties for non-compliance. This could ultimately decrease access to care, which is contrary to the goal of the new Medicaid rule.
New Medicaid Rules can Have an Impact on Your Estate Planning
Families can take strategic steps to accommodate any increase in cost or loss of coverage related to the new rules.
Medicaid is already complex and full of rules that can be hard to follow. Contact an elder law attorney or other local financial professional for assistance. You can begin strategizing to save money and better afford retirement from there.
Remote patient monitoring and telehealth can fill gaps in care, especially if Medicaid providers become less accessible. Area agencies on aging, senior centers and nutrition programs can provide additional support and financial relief.
Navigating the new Medicaid rules can be confusing. However, you don't have to do it alone. Schedule a consultation with our experienced estate planning attorneys today. We can discuss how the new rules affect you and help prepare for tomorrow’s care needs.
Schedule your phone consultation: THE LAW OFFICES OF CLAUDE S. SMITH, III
New Medicaid Rules can Have an Impact on Your Estate Planning
Reference: LeadingAge (2024-04-29), "Final Medicaid Access Rule Includes Controversial 80% Compensation Pass-Through"
Legal problems are extremely stressful, especially when your family, your health, or your freedom are at stake. At this point in time, you may not even be sure what kinds of questions you need to ask a lawyer, but that’s entirely normal. Whether your situation involves family law, estate planning, elder law, a criminal charge, or a personal injury, we will start by giving you all the information you need.
The way we see it, you deserve to get this information directly from an expert. That’s why we make it easy for you to get in touch with your lawyer, and we never ask you to sit down with a paralegal or assistant instead.
As our relationship continues, we will keep you updated about the status of your case every step of the way. Your lawyer will reach out regularly to tell you about any new developments, and he will also be happy to answer any questions you have throughout the process.
