On February 3, LeadingAge and AHCA sent a joint letter to CMS asking for a meeting to discuss two key issues related to Medicaid rate setting primarily for nursing homes. The first issue relates to states that are transitioning from RUGS to PDPM for Medicaid rate setting and the need to clarify the timeline for completing that transition as October 2025. There are concerns some states are rushing to complete this effort by October 2023. The second issue applies to cost-based reimbursement states for nursing homes and/or assisted living providers. LeadingAge understands some states are choosing to treat Employee Retention Credits as more of a one-time grant while other states feel obligated to require providers to offset costs related to the credit. The letter encourages CMS to not require the funds to be offset based upon the intent of the funds, which was emergency assistance. LeadingAge looks forward to discussing both of these issues further when we meet with CMS on February 9.