New Medicaid waiver for HCBS worries providers

Nursing homes are concerned about a new federal waiver that allows the state to reform its long-term care program to emphasize home- and community-based care.

Advocates reportedly fear that “intermediaries” will make decisions about who needs Medicaid-financed nursing home care based on the spending needs of the state, and not the needs of individual residents. Rhode Island faces a $357 million deficit this year.

The Centers for Medicare & Medicaid Services approved the waiver in late December in exchange for a $12.1 billion limit on spending. The waiver gives the state greater flexibility in redesigning its Medicaid program, including the long-term care component. The Legislature was expected to determine whether to approve the waiver by late last month.