Today's deep dives look at the Nov. 14 end date for Ohio's freeze on new Medicaid home care and waiver providers and at a Georgia plan for two state-funded homes for adults with intellectual and developmental disabilities that was canceled after neighborhood opposition. Below are the day's other stories, each linked to its source.
Today's deep dives
Ohio waiver provider enrollment freeze set to end Nov. 14. Since May 14, Ohio has not accepted new Medicaid enrollments for home health, hospice and waiver provider types, including the types used by developmental disability agencies and independent providers. We explain what the freeze covers, what existing providers can still do, how the federal rule handles extensions and what it means for provider agencies and DSPs.
Georgia: DeKalb IDD care homes scrapped after neighbor pushback. Claratel Behavioral Health ended a DeKalb County project for two homes, each for up to four adults with intellectual and developmental disabilities. The plan carried a $20-an-hour starting wage for direct care staff and about $3.5 million a year in state operating money. We cover what was planned, the zoning dispute and Georgia's waiver planning list.
More news today
Georgia: Pathways, the state's work-rule Medicaid program, could end with the year. KFF Health News reports that Georgia Pathways to Coverage, which ties Medicaid coverage for low-income adults to 80 hours a month of work or other qualifying activities, is set to expire at the end of 2026 unless renewed. As of Oct. 9, 20,606 people were enrolled. State officials say bringing Pathways in line with the new federal work rules, which include more exemptions, such as for people caring for someone with a disability, would cost an estimated $1.4 billion more by mid-2028. They have asked CMS for more federal money, and the next governor will decide the program's future. Source: KFF Health News
Medicaid work rules: which high-unemployment counties will be exempt is still unclear. The federal work requirements that start in January let states seek a short-term hardship exception for enrollees in counties where unemployment is at least 8%, or 1.5 times the national rate if that is lower. KFF Health News reports CMS has not said what time frame of unemployment data states should use. KFF's analysis found 95 counties would qualify using July 2026 rates and 120 using a 12-month average. California has asked to use its own state data and is waiting for an answer. For DSPs and other direct care workers covered by Medicaid in those counties, the exemption would decide whether they have to report work hours. Source: KFF Health News