The Idaho Division of Medicaid is seeking public comment on plans being submitted to the federal government to set new rates and methodology to reimburse providers of supported living services. These services help developmentally disabled adults live in their own homes rather than in an institution or certified family home.
The proposed amendments are the result of an intensive cost survey conducted of supported living providers earlier this year, followed by stakeholder meetings for additional input and analysis. If approved by the federal government, Idaho Medicaid anticipates the new methodology and rates will go into effect on April 3, 2017.Based on the cost survey and stakeholder meetings, the new rates for supported living services are:
|
Proposed Rates |
|||
|
Individual |
Group | High Needs |
Intense Needs |
| $19.68/hour | $7.88/hour | $236.16/day |
$472.32/day |
While the provider cost survey was being conducted, Medicaid implemented temporary supported living rates beginning last February until new rates could be established. Medicaid originally intended to reconcile with providers if the new rates differed by more than 5% of the temporary rates. Some of the new rates have at least a 5% difference compared to the temporary rates, but based on the negative impact a claims reprocessing and recoupment may have on participants’ access to services, Medicaid does not plan to pursue recoupment of the difference.
Idaho Medicaid is now accepting written and recorded comments through the end of business Thursday, December 15, 2016, regarding the proposed amendments. Additionally, Medicaid will hold a public hearing concerning the waiver amendments on Tuesday, November 29, 2016, at 2:00 pm (MST), and a provider Q&A session concerning the waiver amendments on Monday, December 5, 2016, at 2:00 pm (MST). The public may participate in these meetings in person at the Medicaid Central Office or via toll-free teleconference.
Detailed information regarding the proposed changes, public meeting dates and locations, and ways to submit public comments, can be found on the Department’s website under the “Proposed Changes to §1915(c) Waivers” in the right hand column at: http://healthandwelfare.idaho.gov/Medical/Medicaid/tabid/123/Default.aspx.
DHW Voice 
As an Agency providing Service Coordination to adults on the DD Waiver and receiving supported living services. After review of the proposed rates, it would appear that sufficient consideration was not given to those choosing to live in independent living situations with out multiple room mates. The result of the lower rates will deny those individuals their personal choice of being able to maintain their residence and continue to receive supported living services for skills training and supports in daily living. End result will be the denial of their personal right to live in the lest restrictive environment.
Thank you for the comment, Chris. We are also concerned about people being able to choose the living setting that works best for them. We are working on support for more accurate billing methods that we hope will address that. We plan on discussing it with residential habilitation providers at a meeting at the Medicaid offices at 3232 Elder St. at 2 PM on Dec. 5.
Matt Wimmer, administrator, Division of Medicaid