Rose Up Against MFAR

It was all hands on deck in January as LeadingAge worked furiously to prepare our comments on the proposed Medicaid Fiscal Accountability Regulation (MFAR)—and help LeadingAge members do the same.

The rule proposed by the Centers for Medicare & Medicaid Services (CMS) governs the use of Medicaid supplemental payments for nursing homes. If finalized as written, it could have significant implications for life plan communities in states that have exemptions or discounts for these communities in their nursing home provider tax policies.

In the last few weeks, we have identified 18 states that currently exempt life plan communities from the Medicaid tax program or levy a discounted tax on those communities. Those practices would be out of compliance with MFAR in its current form. Armed with that information, we joined with the National Continuing Care Residents Association to release a letter requesting that senators and congressmen from the 18 states ask CMS to withdraw or revise the proposal.

LeadingAge released several resources to help providers rise up against MFAR, including a comment guide for providers planning to submit comments to CMS by the Feb. 1 deadline, and a script for members to use in calls to Congress. We also held 2 member call-ins for more than 150 people, and met with House and Senate staff to request protection for life plan communities under the proposal.

Weighed In On 5 Issues

In other advocacy news, LeadingAge spoke up for you on 5 important issues this month:

Hospice: We opposed a decision by the Medicare Payment Advisory Commission (MedPAC) to recommend that Congress implement no Medicare payment increases for hospices in Fiscal Year 2021. But we applauded MedPAC’s effort at “thinking creatively” about how to be more targeted in its recommendation for a 20% reduction in the aggregate payment cap.

“Recommendations for payment adjustments that target specific behaviors that run counter to policy goals, as opposed to blunt approaches of across-the-board cuts, is a direction that LeadingAge encourages MedPAC and Congress to consider more routinely,” we said in a statement.

Fair Housing: We strongly opposed proposed Fair Housing Regulations that would weaken efforts to reduce housing discrimination and segregation in the United States. “In the housing sphere, no laws deserve as much aggressive oversight as the nation’s fair housing laws,” LeadingAge President and CEO Katie Smith Sloan told McKnight’s Senior Living.

Nursing Home Compare: We responded to plans by CMS to combine and standardize its 8 separate Compare websites. We urged CMS to use the website overhaul as an opportunity to improve Nursing Home Compare by incorporating the resident’s voice and reconsidering use of the consumer alert icon. Janine Finck-Boyle, vice president of regulatory affairs, addressed the icon issue in McKnight's Long-Term Care News and Market Watch.

MDS: We asked questions (and lots of them) about a planned move by CMS to eliminate Section G from the Minimum Data Set (MDS). The move could potentially result in unintended financial and administrative consequences for Medicaid providers that rely on Section G to receive proper reimbursements. “Right now, we don’t really have a full treasure chest of answers,” Finck-Boyle told Skilled Nursing News.

ANSI Standards: We joined other organizations in filing appeals requesting that the American National Standards Institute (ANSI) reconsider its decision to make Argentum an accredited developer of voluntary standards in the senior living industry. LeadingAge’s opposition, which is shared by others, is focused on concerns regarding due process, dominance and openness, and lack of balance in the Argentum proposed standards development process. ANSI scheduled a hearing for February.

Provided Thought Leadership

There were plenty of opportunities in the early days of January for LeadingAge thought leaders to share their predictions for how our field will evolve in 2020 and beyond.

Asked by Skilled Nursing News about the biggest challenges and opportunities of 2020, Katie Sloan predicted that nursing homes’ viability will continue to be a theme. In addition, Sloan told McKnight’s Senior Living that “addressing the needs of middle-income consumers and developing affordable housing, providing more options that allow aging in place … will, increasingly, garner more interest from and attention of providers.”

Sloan also predicted that workforce issues would dominate the coming year, a theme echoed by Robyn Stone, senior vice president of research and co-director of the LeadingAge LTSS Center @UMass Boston. Stone told Modern Healthcare that the personal care workforce is doing “sophisticated work such as observing changes in condition. Better wages can help, but the work environment is the most important ingredient” for strengthening the workforce in the 2020s.

Developed New Resources For You

We’ve produced a number of resources this month to help you carry out your work: