Today, HCP and 1199 SEIU jointly sent a letter to the Cuomo Administration to urge support for provider PPE expenses. In the letter it was highlighted that LHCSAs and Fiscal Intermediaries (FIs) in CDPAP provide personal and home health care to vulnerable, nursing home eligible persons, keeping the most vulnerable safely at home and away from the risks of Covid-19. It was noted that the vast majority of these long term supports and services are paid for by Medicaid through Medicaid managed long term care plans (MLTCPs).
Moreover, providers have faced increased costs during the pandemic. The most significant additional expense has been the cost of PPE, which will likely be over 1000% higher than it was in 2019.
LHCSAs and FIs continue to do their part to ensure both worker and patient safety and comply with all of the State directives to combat this crisis. These additional, unreimbursed costs, however, are unmanageable and annualized are financially unsustainable.
Since the beginning of the pandemic, a percentage of home care clients have chosen to refuse service due to increased concerns about exposure to the coronavirus with workers coming in and out of the home as well as increasing availability of family caregivers due to higher unemployment. However, MLTC plans continue to receive their per member per month premium for each enrollee. Using 2018 cost report data (the most recent available), we estimate that a 12% reduction in service hours generates approximately $52 million per month in revenue retained by the plans.
The letter concluded that in order to support MLTC members, HCP and 1199 SEIU urge DOH to require a redistribution of the underspending to MLTC’s LHCSA and FI providers to support the acquisition of PPE for workers as well as other new pandemic-related costs like overtime, sick pay and premium pay for workers caring for coronavirus patients. MLTCs could pass through the funding as rate adjustments, lump sum payments, or other calculations—the simpler and faster the better.
HCP will continue to find opportunities to ensure providers have the resources they need to meet the demands of the COVID crisis.