Gov. Justice, DoHS announce increase in provider waiver rates and IDD waiver expansion

CHARLESTON, WV (WVDN) — Gov. Jim Justice and the West Virginia Department of Human Services (DoHS) announced that providers have been notified that the Bureau for Medical Services (BMS) will increase provider waiver rates by 15% on October 1, 2024, the amount as recommended in the service cost and rate review conducted by Myers and Stauffer LC and released on December 8, 2023.

The Governor discussed the expansion during his weekly administration briefing.

A waiver rate increase will also occur for family support, as well as personal care rates on October 1. In addition to rate increases, BMS will remove an additional 50 Intellectual/Developmental Disability (IDD) members off the waitlist. This is in addition to the 99 members who were removed from the waitlist on July 1, 2024. The total cost to remove 50 members from the waitlist is $3.9 million per year.

“Ensuring that our providers are compensated fairly and that more West Virginians can access the services they need is a top priority,” said Cindy Beane, DoHS Bureau for Medical Services Commissioner. “An October 1 start date will allow the Bureau for Medical Services to notify federal partners and make adjustments needed in our technology systems to ensure a smooth implementation of these important changes.”

In 2023, BMS engaged Myers and Stauffer LC to review service rates and make recommendations for rate revisions provided on the Intellectual/Developmental Disability (IDD) Waiver, following the directives of West Virginia Senate Bill (WV SB) 617. BMS expanded the review to include the Aged and Disabled (AD) Waiver, the Traumatic Brain Injury (TBI) Waiver, and the personal care (PC) state plan service. The project responds to WV SB 617, which provides a directive to determine recommended levels of reimbursement for home and community-based services (HCBS) providers serving individuals with IDD. The rate review and recommendation process included a provider cost survey, significant stakeholder engagement, geographic review, and peer state research.

Issues raised by waiver and state plan service providers have included workforce pressures, staffing shortages, turnover, and reimbursement levels. The expansion of this rate rebase initiative to include the AD and TBI waivers and PC service allowed BMS the opportunity to review rates for a larger population of service recipients, examine the alignment of rates for similar services across waivers, and provide consistent rate change recommendations that do not create an imbalance that may lead to workers favoring employment in one type of services over another due to provider ability to fund wages.

BMS will monitor the impact of increased rates on member access to services as well as worker pay and turnover rates to determine if the increased rates are having the desired effect on workforce availability and tenure.

To view and apply for career opportunities that support West Virginia families, visit dhhr.wv.gov/Pages/Career- Opportunities.aspx .

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