Current Actions

Urge Your Senator to Support Home Care Licensure

Tue, 04 Nov 2025 05:00:00 GMT

After the State House of Representatives vote to pass H.4306, An Act to Improve Massachusetts Home Care, which would create licensure system that would establish baseline standards for agencies, attention now turns to the Senate.

Massachusetts remains one of a handful of states without a licensure structure as a condition to provide home care services. In 2017, Governor Baker signed into law a framework for the Department of Public Health to establish a licensure structure for 'skilled' home health services. This framework did not include nonmedical personal care services.

For many years, the Home Care Alliance has supported and advocated for legislation which would establish a licensure structure in Massachusetts. It is our vision that this regulatory structure would establish a baseline set of standards for home care agencies to comply with in order to lift up the industry at large and protect consumers.

Please use this action alert to urge your state Senator to support this key piece of legislation!

Urge Congress to Block Catastrophic Home Health Care Cuts

Thu, 30 Oct 2025 04:00:00 GMT

In July, the Centers for Medicare & Medicaid Services (CMS) released their FY 2026 Home Health Final Payment Rule, which proposes over $1.1 billion in cuts to home health payments for 2026. If finalized, these cuts would further destabilize access to care at home for millions of seniors and put home health providers at serious risk.

Congress never intended the Bipartisan Budget Act of 2018 to be used to justify cuts of this magnitude. CMS’s analysis relies on questionable data, and its methodology has numerous flaws, raising serious concerns about the accuracy and fairness of the proposed cuts.

The Home Health Stabilization Act of 2025 (H.R. 5142), introduced by Representatives Hern [R-OK] and Sewell [D-AL], would pause cuts in 2026 and 2027 to ensure that beneficiaries continue to have access to necessary services and that home health agencies are able to continue to provide these services. Congress must act now to preserve home health care because once providers close their doors, they rarely come back.

Urge Your State Legislature to Support a Cap on Temporary Staffing for Home Health and Hospice Services

Fri, 24 Jan 2025 05:00:00 GMT

In recent years, we have seen temporary nurse staffing (TNS) agencies become increasingly active in the home health and hospice care delivery arena. Historically – home health and hospice agencies have utilized TNS’ on an emergency basis. But more recently, provider agencies have faced an influx of interest in the home-based care space by these TNS’. Because these entities demand contracts that far exceed what is currently reimbursed to home health and hospice agencies, they pose a threat to providers' ability to recruit and retain its workforce. This will threaten older adults' access to available home health and hospice services. Currently, there is a Department of Public Health (DPH) regulation which sets caps on temporary nurse staffing rates. However – the underlying Massachusetts General Law (MGL) which gave DPH authority and directed them to establish this regulation, did not include home health and hospice.

Because of this, Senator John Velis and Representative Paul Donato have introduced legislation which would amend the MGL to include home health and hospice and which would give DPH the authority to set caps temporary nurse staffing rates for home health and hospice services.

Use this action alert to urge your legislator to co-sponsor H.2408/S.1633, An Act Relative to Staffing at Home Health and Hospice Agencies.

Urge Your Legislator to Support Licensure of Home Care Services

Thu, 23 Jan 2025 05:00:00 GMT

Take action today by writing to your state legislators urging them to co-sponsor S.2555/H.4306, an Act to Improve Massachusetts Home Care, which would create a licensure system that would establish baseline standards for agencies, to ensure a quality network of providers for consumers and keeping services affordable for those who rely on them.

Urge Legislator to Support Extension of Telehealth Flexibilities

Tue, 17 Dec 2024 05:00:00 GMT

Due to the current government shutdown, crucial telehealth flexibilities have lapsed. Originally created during the first Trump administration, these telehealth flexibilities expanded the types of practitioners eligible to offer telehealth services and allow Medicare beneficiaries to receive virtual care in their homes and through audio-only calls. home-based care patients and providers have benefited immensely from authorized telehealth flexibilities for the Face to Face (F2F).

Sadly, Effective 12:00 a.m. on October 1st, F2F encounters for certification and recertification must be conducted in person. Audio-visual telehealth is no longer acceptable to meet this requirement.

Losing these flexibilities has put a strain on already limited staff resources, leading to a lowering in overall care for patients who need them the most. Providers cannot continue to spend precious time traveling and accruing the costs and risks involved. Providers need to be given the ability to provide care for those who need it in a way that is most convenient.

We need your help! Please use this action alert to urge Members of Congress to support telehealth extension being included in any final budget or CR proposal.

Support Reforms Home Care Rate Setting Processes

Thu, 30 Oct 2025 04:00:00 GMT

Currently, agencies have been heavily reliant on non-guaranteed supplemental rate add-ons that have been passed by legislators through the state budget process. The Alliance has been actively working to pass legislation that would end the need for the Legislature to fund these supplemental rate add-ons for home care and home health workers every year. The goal is to ensure the existing rate setting process works and provides consistent rates that accurately reflect the true cost of providing home care and home health services to consumers across the Commonwealth.

This legislation would clarify the rate setting processes that are already in place for both home health and home care services. It does not set the rates or dictate the amount for future rates set by Mass Health and EOHHS. It would make the rate setting process more transparent and ensure rates set by the state follow proper laws and reflect the actual operating costs incurred by home health and home care providers.

Use this action alert to write to your legislator urging them to co-sponsor S.870/H.767, An Act Clarifying Rate Setting Processes for Home Care Services.

Tell Congress to stop the Medicaid HCBS 80/20 pass through!

Thu, 15 May 2025 04:00:00 GMT

In the Medicaid Access Rule CMS finalized a requirement that no less than 80% of all Medicaid payments, including but not limited to base payments and supplemental payments, be spent on compensation to direct care workers, for homemaker services, home health aide services, and personal care services. This requirement applies to services delivered under sections 1915(c), (i), (j), (k), and potentially also 1115 of the Social Security Act as well as those delivered through managed care contracts. Notably, it would not apply to 1905(a) State plan personal care and home health services.

The rule defines “compensation” narrowly as:

Salary and wages;
Benefits (such as health and dental benefits, paid leave, and tuition reimbursement);
The employer share of payroll taxes for direct care workers; and
Other remuneration as defined by the Fair Labor Standards Act

Importantly, the rule’s definition neglects to include other crucial costs necessary to provide services.

There are significant negative outcomes that would occur if the 80-20 provision is finalized, including:

This provision will reduce, not increase, access. Individuals who rely on HCBS to live their lives in home-based settings will lose services, particularly if providers cannot meet these new requirements or are forced to restrict innovative, value-added care supports.
The provision appears to have been arbitrarily created and not based on data or an explained rationale.
The restrictive threshold definitions will serve to limit resources for caregiver support and other enhanced care-focused operations, resulting in reduced quality, health and safety, and oversight in HCBS.
The blanket approach undermines state autonomy, creates stark inequities across and within states, limits the ability to modify program requirements, and penalizes providers and states that have more regulation and oversight.
The provision seeks to establish precedent that CMS/HHS has the authority to dictate how state Medicaid dollars are spent by private entities.
CMS imposes this mandate with no existing or planned infrastructure for collecting and reporting out accurate information, financing to support added resource needs, or data to ensure that the dollars are being distributed as intended.