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HCBS Update with NAHC—Outlook for Payment Adequacy Standard Rule

This year, the Biden administration will look to finalize a host of health care policies before the election, including the anticipated Medicaid Home- and Community-Based Services (HCBS) payment adequacy rule. The proposal, which has been met with state and provider objections, would require that 80% of HCBS Medicaid payments under 1915(c) waivers be allocated to salary, wages, benefits, and employer payroll taxes for personal care services, homemaker services, and home health aides. The final rule arrived at the Office of Management and Budget in late January, and the current Unified Regulatory Agenda lists a target publish date of April 2024. To discuss provider priorities and different scenarios ahead of the final rule, Marwood’s Joe Mercer and Sherill Mason hosted a call with Damon Terzaghi, Director of Medicaid Advocacy at the National Association for Homecare and Hospice.

Key Topics Include:
  • Provider priorities for final rule and landscape under different scenarios
  • Potential regulatory read-through from other recent rules (e.g., SNF staffing)
  • Appetite for Congressional relief
  • Outlook for administrative consequences if Chevron case is overturned
Thursday, February 15, 2024
11 a.m. ET
Inquire About Key Takeaways
Damon Terzaghi
Damon Terzaghi
Director of Medicaid Advocacy, National Association for Homecare and Hospice
Damon Terzaghi

Mr. Terzaghi has spent his career working in programs that support older adults, people with disabilities, and low-income families. Currently, he is Director of Medicaid Advocacy at the National Association for Homecare and Hospice, where he is responsible for establishing the Association’s Medicaid-specific regulatory, legislative, and technical assistance priorities; providing information and analysis to members regarding issues in Medicaid that impact Homecare, Hospice, and HCBS; and developing NAHC’s Medicaid-specific resource library. Prior to NAHC Mr. Terzaghi served as Senior Director at ADvancing States, the association representing state government aging, disability, and long-term services and supports agencies; he also served as a Vice President at Marwood Group, and has served in both federal and state agencies, including the Centers for Medicare and Medicaid Services and Oregon’s Department of Human Services. He holds a Bachelor of Arts Degree from Willamette University and a Master of Science in Public Health Administration from Trinity Washington University.