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Lawmakers hear proposal to raise targeted HCBS provider rates amid workforce, rural access concerns
Summary
Agency officials told the House appropriations panel that North Dakota’s in‑home provider rates lag regional benchmarks; they proposed targeted rate increases for specific HCBS services, citing provider recruitment challenges, higher client acuity and shifting service mixes that require nurse involvement and 24‑hour supports for some clients.
Nancy Nicholas Meyer and Division of Medical Services director Sarah Achor explained to the Human Resources Appropriations panel that provider wages and agency reimbursement for many in‑home and HCBS services have not kept pace with regional benchmarks and rising demands.
Achor summarized Medicaid obligations and long‑term care policy context before returning the floor to Meyer for HCBS specifics. Sarah Achor noted that Medicaid is an entitlement program that requires federal compliance and federal match; she said states can limit waiver slots but not generally deny eligible individuals access to Medicaid services.
Meyer described several cost drivers and the division’s targeted rate proposal. She told lawmakers that…
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