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News Releases >> Nation’s Assisted Living Leaders Urge Congress To Extend FMAP and To Implement Part D Co-payment Provision

Washington, DC –State Leaders of the National Center for Assisted Living (NCAL) from across the country are meeting with their Senators and Representatives today and tomorrow asking them to pass an extension of the enhanced Federal Medical Assistance Percentage (FMAP). They also are urging the U.S. Department of Health and Human Services to implement a provision of the recently enacted health care reform law that eliminates Medicare Part D copayments for dual eligibles—individuals eligible for Medicaid and Medicare—in assisted living as soon as possible.

NCAL state leaders, representing 18 states, are participating in nearly 60 meetings on Capitol Hill with Senators, Representatives, or congressional staff.

If Congress does not extend the temporary increase in FMAP funding, states will confront an 8 percent drop in federal Medicaid funding on Jan. 1, 2011. The enhanced funding was originally passed as part of the American Recovery and Reinvestment Act of 2009 (ARRA). The enhanced FMAP should be extended by six months, according to the State Leaders.

Medicaid is the largest payer of long term care and services providing support for 13 percent of the nation’s assisted living residents and 64 percent of the nursing facility patients. About 46 states offer assisted living to beneficiaries through Medicaid waiver or state plans.

The average assisted living resident is an 87-year-old woman with a median annual income of $19,000, according to national research study.

“The temporary FMAP increase is vital to preserving assisted living residents’ ongoing access to their care and services,” says David Kyllo, NCAL’s executive director.

Kyllo also remarked that the recently enacted health care reform law includes a provision that requires Medicare Part D to cover drug copayments for dual eligibles in residential settings no earlier than Jan. 1, 2012. However, as written, the law does not include a firm deadline for implementation.
NCAL State Leaders are asking members of Congress to send a letter to Health and Human Services Secretary Kathleen Sebelius to implement Medicare Part D co-payments by Jan. 1, 2012.

“NCAL believes that eliminating the co-payments by Jan. 1, 2012 will require the Centers for Medicare & Medicaid Services to begin working on the implementation during 2011 to communicate the changes to the payment systems, Part D plan networks, and the states,” says Kyllo.

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