Medicaid home care aide services providers need to act quickly to avoid the risk of non-payment for services. The New York State Home Care Worker Parity Act, Public Health Law § 3614-c, establishes minimum “total compensation” requirements for “home care aides” who perform Medicaid-reimbursed work for certified home health agencies (“CHHAs”), long term home health care programs (“LTHHCPs”) and managed care plans (“MCPs”). The Act applies to both mainstream managed care plans and all forms of managed long term care plans, and also affects licensed and limited licensed home health care services agencies to the extent that they contract with a CHHA, LTHHCP or a MCP to provide services to Medicaid clients of those entities in the designated locations. The Act’s compensation requirements are intended to establish wage parity among various types of home care workers in New York City and Nassau, Suffolk and Westchester counties.
KEY PROVISIONS OF THE ACT:
- Beginning on March 1, 2012, covered employers will be required to pay New York City “home care aides” a minimum wage rate of $9.00 per hour, plus either provide health benefits or pay a benefit supplement rate of $1.35 per hour for a minimum total compensation of $10.35 per hour (equating to 90% of the total compensation mandated by the Living Wage Law of New York City).
- Minimum total compensation requirements for home care aides in Nassau, Suffolk and Westchester counties will begin on March 1, 2013.
- The Medicaid reimbursements rates for CHHAs, LTHHCPs and MCPs are not being increased at this time.
- “Home care aide” means a home health aide, personal care aide, home attendant or other licensed or unlicensed person whose primary responsibility includes the provision of in-home assistance with activities of daily living (“ADLs”), instrumental ADLs or health related tasks, but excludes aides “working on a casual basis,” (which, according to the New York Department of Health (“DOH”), means those working on an “incidental, irregular and/or intermittent basis.”) For additional information, see Home Care Worker Wage Parity FAQs, January 2012.
- CHHAs, LTHHCPs and MCPs must provide the DOH with annual written certifications that all services provided are in full compliance with the terms of the Act, on NY DOH Forms prepared by the DOH.
- For covered entities that contract for home care aide services with licensed home care services agencies or other covered third parties, the CHHA, LTHHCP or MCP must obtain written certifications from such third parties which attest to the third party entity’s compliance with the terms of the Act. The certifications also obligate the CHHA, LTHHCP and MCP to obtain, on a quarterly basis, all information from the third party necessary to verify compliance with the terms of the Act. All certifying parties are required to maintain certifications and all information exchanged between them for a period of ten years.
- The portion of the minimum compensation rate relating to health benefits are superseded by any collective bargaining agreement that was in effect as of January 1, 2011, or a successor to such an agreement, which provides health benefits to home care aides through payments to a jointly administered labor-management fund.
- Failure to fully comply with the Act, including the timely submission of the required certifications, will result in non-payment for any covered services rendered after March 1, 2012.
IMPACT OF THE ACT:
First, covered employers that pay aides less than $9.00 per hour currently will have to raise pay rates (and provide the benefit supplement) with no corresponding reimbursement increase from Medicaid. Also, covered entities undoubtedly will have questions as to the intended meaning of various parts of the Act, notably the phrase “working on a casual basis,” as many home care aides work for one or more employers on a per diem basis, and the definitional guidance provided by the DOH does not clearly address those particular employment circumstances.
Nonetheless, beginning March 1, 2012, no payments will be made to covered providers unless they have filed the required certifications of compliance. Prior to filing certifications of compliance, home care organizations should perform all appropriate testing and review to ensure that each certification is accurate when made.