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House Human Services urged to restore surprise cut to residential care Medicaid rate; JFO estimates $1.07 million fix
Summary
Presenters told the committee that implementation of a rate study produced an unexpected 33–35% cut to ERC tier 1 reimbursement; the Joint Fiscal Office estimated $1,071,550 would be required to restore the rate, and committee staff were asked to draft BAA language.
Helen Laban, executive director of the Vermont Health Care Association, told the House Human Services committee that implementation of a Medicaid "enhanced residential care" (ERC) rate structure produced an unexpected and substantial cut to ERC tier 1 payments that took effect July 1.
"It was an unpleasant surprise," Laban said, describing tier 1 cuts of roughly 33–35 percent in some cases. She said ERC tier 1 is the threshold when residents first cross into a nursing-home level-of-care classification and that the reduction has financial effects for residential care homes and…
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