WV Medicaid Recipients' Union : Independent Contracting


◊ HOME ◊ CONTACT US ◊ MISSION ◊ MEMBERSHIP ◊ CALENDAR ◊ POSITIONS Independent Contracting ◊ COMMITTEES ◊ WV MEDICAID ◊ LEGISLATIVE ◊ ELECTIONS ◊ LINKS ◊ JOB MATCH	INDEPENDENT CONTRACTING ~ CONFLICTING INTERESTS ~
	Let's take a look at independently contracted direct care services (Respite and Adult Companion Care) under the MR/DD waiver program. The Medicaid reimbursement for Level I (contracted) Respite or Adult Companion Care is $10.00 per hour. The Medicaid reimbursement for Level II (agency employee) Respite or Adult Companion Care is $12.50 per hour. Thus, the service provided by agency employees costs Medicaid $2.50 per hour MORE than the independently contracted service. Per the waiver regulations, the job duties are the same. Each MR/DD waiver participant may receive up to 144 hours of Respite Care and/or 654 hours of Adult Companion Care per month. There are approximately 3,844 participants on the MR/DD waiver program. At maximum program levels, Level I Respite Care would save Medicaid over $16 million annually, and Level I Adult Companion Care would save Medicaid over $75 million annually. Of course, these services are not provided at maximum program levels to each individual. So, let's assume* for the sake of argument that participants are receiving just 10% of the available services (i.e., roughly 80 hours) each month. We're STILL talking about a savings of over $9 million annually. NINE MILLION DOLLARS! And yet, DHHR officially made these contracted services "optional" due to Wage & Hour and IRS issues. Very few behavioral health agencies will now provide the Level I services, even though program participants and their interdisciplinary teams (IDTs) typically choose them over the Level II variety. The Level I services are preferred because staff are better paid, resulting in higher quality of care and lower turnover. This, in turn, results in more progress toward program goals & objectives which then results in increased independence and decreased reliance on waiver supports. Rather than invest in the development of policy to alleviate such concerns, DHHR apparently believes it can disregard such potential savings. Staggering, isn't it?
	* MRU WV wouldn't have to guesstimate these figures if BMS would simply respond to FOIA requests for billing data. BMS claims that does not have this information. That doesn't exactly inspire confidence in a bureaucracy entrusted with the responsible management of public funds.
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This page last updated Friday 17 June 2005