Medicaid
CMS holds back another $1.2 billion in California Medicaid home care payments
Federal officials are expanding a fraud review of personal care services — the same kind of in-home help many families depend on. Payments held back in California don't change New York care today, but the same review approach could spread.
Key facts
- CMS said on October 20 it will defer $1.2 billion in federal Medicaid payments to California for personal home care services.
- It follows a July deferral of more than $1 billion for similar services in Minnesota and California.
- A deferral holds money back until the state shows claims meet federal rules; it is not a cut to anyone's benefit.
What happened
On Tuesday, October 20, the Centers for Medicare & Medicaid Services (CMS) said it would defer $1.2 billion in federal Medicaid payments to California for personal home care services. CMS Administrator Dr. Mehmet Oz announced it at an Oval Office briefing and said the agency has "at least two more years of hard work" on fraud.
This follows a July deferral of more than $1 billion in Medicaid payments for personal care and home-based services in Minnesota and California. Oz said California's personal care services grew by more than 24% over three years. Sen. Alex Padilla of California said the decision "will hurt older Californians, people with disabilities and those recovering from illness or injury."
A deferral means the federal government holds back money until the state shows the claims meet federal rules. It is not a cut to any person's benefit.
What it means for families
Families outside California are not directly affected. The bigger signal is that federal and state regulators are looking closely at Medicaid home care and personal care billing nationwide, including in New York. Expect more paperwork, documentation checks and provider reviews.
Quick answers
Why is CMS holding back California Medicaid home care payments?
On Tuesday, October 20, the Centers for Medicare & Medicaid Services (CMS) said it would defer $1.2 billion in federal Medicaid payments to California for personal home care services. CMS Administrator Dr. Mehmet Oz announced it at an Oval Office briefing and said the agency has "at least two more years of hard work" on fraud.
Is a Medicaid deferral a cut to anyone's benefits?
A deferral means the federal government holds back money until the state shows the claims meet federal rules. It is not a cut to any person's benefit.
What to do this week
- If a parent gets Medicaid home care, keep a simple log of the aide's visit days and hours.
- Save every letter from the Medicaid plan or agency, and open mail from them promptly.
- If a provider asks you to sign for hours that weren't worked, don't sign it.
Sources
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