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Press Release | Medicaid

NAHC Expresses Disappointment Regarding Medicaid Access Final Rule

April 22, 2024

April 22, 2024

Washington, D.C. – As an organization dedicated to increasing access to services that allow people to receive compassionate, expert care in their homes and communities, the National Association for Home Care & Hospice (NAHC) is extremely disappointed that the Centers for Medicare and Medicaid Services (CMS) elected to finalize the “payment adequacy” provision in the Medicaid Access Final Rule (CMS 2442-F). This is a misguided policy that will result in agency closures, force providers to exit the Medicaid program, and will ultimately make access issues worse around the country. As NAHC and our partners across the home care industry have demonstrated, such a provision is not only unworkable due to the varied nature of Medicaid programs across the country, CMS also lacks statutory authority to impose this mandate.

According to Jennifer Sheets, co-chair of the NAHC Medicaid Advisory Council (MAC), “We know that CMS has good intentions and a desire to improve the lives of workers, but this policy is ill-advised and will have serious negative impacts on providers and their clients around the country.” David Totaro, President and Executive Director of BAYADA Hearts for Home Care and NAHC MAC co-chair, expanded, “It is unfortunate that the final rule included a mandatory pass-through requirement. There are so many positive and necessary changes in the regulation, so it is disappointing that this one provision will undermine all the good things about the rule.”

NAHC President, William Dombi promised to continue advocacy against the pass-through requirements, saying, “We all agree that more needs to be done to support the direct care workforce; however, this policy will make things worse, not better. NAHC remains committed to overturning this devastating policy and instead advocating for more feasible and rational policies that address the root causes of low worker compensation.”

NAHC strongly believes in the value of, and care provided by, the direct care workers, and we are deeply committed to finding workable solutions that address the struggles of this valuable group of people. Unfortunately, the realities of the various Medicaid programs around the country make any uniform requirement a nonstarter. You can learn more about the Access final rule and receive updates on NAHC advocacy at the NAHC website.

Attend our webinar on Thursday, April 25, 2024 to learn more. Register here.


About NAHC

The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice. NAHC represents the nation’s 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ. These caregivers provide vital services to Americans who are aged, disabled, and ill. Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information. NAHC is a nonprofit organization that helps its members maintain the highest standards of care. To learn more, visit


Media Contacts: Thomas Threlkeld
Director of Communications, NAHC