Earlier this month, over 30 adult day providers with Medicaid certifications in process saw applications denied, with the state citing Governor DeWine’s May announcement of a statewide moratorium on Medicaid certification for home- and community-based services and hospices. While initial communications noted that the moratoria applied to only home care and hospice, this was later expanded to include other home- and community-based waiver services like transportation and adult day services. According to AGE contacts, staff of the Department of Medicaid are working through claims data to identify likely instances of inappropriate billing before forwarding these on to sister agencies.
Notably, none of the initial 49 provider suspensions have included adult day centers.
To date, the moratorium has not been expanded to assisted living waiver providers, which serve Medicaid enrollees under a dedicated HCBS waiver. LeadingAge Ohio has been working to identify members impacted by the moratorium and elevate these issues to key contacts at AGE, Medicaid and PASSPORT administrative agencies (PAAs).
Adult day operators are characteristically different than home care providers, in that they provide care in an environment outside of the private home, which is inspected prior to certification. LeadingAge Ohio believes the protections inherent in the certification process warrant the exclusion of adult day operators from the moratoria and will continue to advocate on behalf of its members.
Questions may be directed to Eli Faes, Director of Public Policy at efaes@leadingageohio.org.