Idaho Medicaid announced today that it will work with providers to conduct a cost survey to evaluate the rates paid to providers of supported living services. During the survey period, Medicaid will pay temporary rates that will go into effect Feb. 1.
These changes do not affect all Medicaid providers, only those who provide community-based supported living services to qualified participants with developmental disabilities.
Supported Living services allow adults with developmental disabilities who choose to live in their own homes up to 24-hour support for personal care, supervision, and to receive help building skills needed to become more independent.
Medicaid had originally announced reinstatement of an approved rate schedule after a U.S. Supreme Court ruling in 2015 that upheld the state’s ability to set reimbursement rates for Medicaid services. Service providers objected and said those rates would be too low, with several suggesting they would no longer participate in the program.
Medicaid heard from providers, advocates and participants about the rates. It was determined there were enough indications of a potential access problem developing to initiate the cost survey and implement temporary rates until the survey is complete.
The temporary rates offer significant increases from the originally announced rates. The temporary rates increase the 24-hour daily intense support rate from $268 to $455, with the daily high support rate increasing from $225 to $273. The hourly rate also increases, from $12.96 to $22.76.
If there is more than a 5 percent variance between the temporary rates and final rates determined by the survey, the difference will be reconciled back to the Feb. 1 implementation date.
As an example, for the intense rate of $455, if the survey rate is lower than $432, providers will repay the state the overpayments they received. The repayments would happen over a period of time. If the survey-determined rate is more than $478, the state will pay providers the difference.
Idaho Medicaid is committed to maintaining access to quality services for participants. The cost survey and temporary rates allow participants to maintain access to services until new rates can be implemented.