The Office of the Investigator General (OIG) in its 2014 Workplan stated that it will be investigating the billing and payments under Medicaid and Medicaid waivers for adult day services. The OIG submitted recommendations to the Centers for Medicare and Medicaid Services (CMS) and states concerning adult day centers that were included in a 2011 report.
The HCBS Setting Requirements final rule CMS–2249–F; CMS–2296–F
was released January 10, 2014 by the Centers for Medicare &
Medicaid Services. This rule will give states more flexibility on how
they are able to use federal Medicaid funds to pay for home- and
community-based services (HCBS) to meet the needs of Medicaid enrollees,
particularly the elderly and disabled.
The LeadingAge report, TRANSPORTATION: A VITAL LINK TO ADULT DAY SERVICES
looks at how adult day programs provide and are paid for transportation
services for participants. Savings from Managed Care, Accountable Care organizations and other
integrated systems cannot be achieved, if the frail older adult has no
reliable, affordable means of getting to and from care services, such as
adult day services.
There are now 17 states participating in the Balanced Incentive Payment Program (BIPP), according to the Centers for Medicare and Medicaid Services (CMS). The deadline for states to apply for BIPP is August 2014.
Rep. Barbara Lee
reintroduced the Adult Day Center Enhancement Act of 2013 (H.R. 3221). If passed, this
legislation would demonstrate the value of adult day services in
caring for individuals with neurological diseases as well as providing
additional support for caregivers and quality care for individuals with multiple sclerosis, traumatic brain injury, and Parkinson's disease.
The Medicare Adult Day
Services Act of 2013 (H.R. 3334), if passed, would expand Medicare beneficiaries care options by adding skilled nursing, rehabilitation and social services in a Medicare Certified Adult Day Services Center. LeadingAge strongly supports this legislation and urges you to contact your legislators and urge their support.