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The Impact on Medicaid of the ACA Employer Mandate and New Overtime Compensation Rules

Beginning January 2015, providers of Medicaid home care services will face the daunting task of complying with two significant changes in the law that could significantly increase care costs. At the same time, state Medicaid programs and their managed care contractors have not shown any willingness to increase payment rates.

The employer mandate under the Affordable Care Act may trigger an employer’s obligation to offer health insurance or face a $2000 penalty for each employee working 30 hours or more per week. A recent survey indicates that an estimated 67% of Medicaid home care providers currently do not offer health insurance to personal care aides.

Additionally, the recent changes to the Fair Labor Standards Act rules by the Department of Labor will require overtime compensation to personal care aides working more than 40 hours weekly. Live-in workers will be affected as well when they are employed by a home care company.

The National Council on Medicaid Home Care, an affiliate of the National Association for Home Care & Hospice, has called on the Centers for Medicare and Medicaid Services (CMS) to convene a stakeholder summit to develop reasoned solutions to the challenges facing Medicaid home care under the Affordable Care Act and the recent overtime rule change issued by the Department of Labor.

Does your private duty home care company serve Medicaid clients?  How will the ACA and the DOL Rule affect your business?  How do you plan to deal with these changes?  Give us your comments below.

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