In response to the proposed Medicaid Fiscal Accountability Regulation, a bipartisan coalition in Congress sent a letter to CMS urging the agency to protect nursing homes and CCRCs/life plan communities from potential impacts from the proposed rule. Read the letter here.

Representatives Donna Shalala (FL-27) and John Rutherford (FL-4) are the lead signers. Representatives Adams (NC-12), Axne (IA-3), Brownley (CA-26), Buchanan (FL-16), Courtney (CT-2), Cox (CA-21), DeLauro (CT-3), DelBene (WA-1), Deutch (FL-22), Fitzpatrick (PA-1), Garamendi (CA-3), Hastings (FL-20), Horn (OK-5), Kilmer (WA-6), Larson (CT-1), Mast (FL-18), Posey (FL-8), Raskin (MD-8), Schrier (WA-8), Soto (FL-9), Velázquez (NY-7), Wasserman Schultz (FL-23), Watson Coleman (NJ-12) and Yoho (FL-3) also signed the letter. 

In the letter, the Representatives write, "Most CCRC nursing homes do not participate in the Medicaid program or do so in a limited capacity. Because of this, many states exempt these communities from paying state provider taxes or assess them a reduced provider tax rate. Under the proposed MFAR rule, retirees across the country who plan carefully for long term care could face increased out-of-pocket costs if CCRCs were to pass the cost to the consumer through heightened entrance fees or monthly fees. While the exact cost of these new taxes would vary by state and by community, the price for seniors living in CCRCs in our communities could be significant to people who live on fixed incomes and have carefully planned for retirement costs, possibly adding several hundred dollars to a resident’s monthly expenses. To that end, we urge CMS to withdraw the proposed changes to 42 CFR § 433.68 or to include language in any final rulemaking that makes clear that state provider tax exemptions and discounts for CCRCs comply with the final rule." 42 CFR § 433.68 refers to federal regulation of state provider taxes.

The letter further states, "We do not believe it’s the intention of CMS to take regulatory action that would increase state taxes or the cost of nursing home care for private-pay residents. The proposed MFAR, however, could do just that by disallowing provider tax exemptions or discounts for nursing homes that serve all or mostly older residents who pay out-of-pocket. This change constricts the availability of high-quality nursing home beds at a time when demand is increasing exponentially. Older Americans who have spent their lives contributing to their communities and planning their retirements will pay the price. We urge CMS to protect these older Americans."

LeadingAge appreciates and thanks this bipartisan coalition of Representatives for taking action to protect CCRCs and the older Americans living in these communities. LeadingAge continues to monitor developments related to the MFAR proposal and will inform our members as updates and opportunities for action become available.