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Comment Tracking Number: 1k2-94p4-ty5d
Agency: Centers for Medicare Medicaid Services (CMS)
Document Type: Rulemaking
Title: Medicaid Program: Reassignment of Medicaid Provider Claims: CMS-2413-P
Document ID: CMS-2018-0090-0001
The Rhode Island Center for Freedom & Prosperity, a 501-C-3 public policy think tank in Rhode Island, respectfully submits comment in support of the proposed rule that would remove the regulatory text at 42 CFR 447.10(g)(4) that allows a state to reassign portions of a provider’s payment to third parties for benefits such as health insurance, skills training, and other benefits customary for employees.
Our comment uses as an example a real-life scenario made possible by 2018 Rhode Island legislation that was signed into law earlier this year … allowing for attempted unionization of the home care industry. This private industry in our state, which now successfully provides vital services, could be decimated.
This proposed Medicaid Provider Reassignment Regulation Proposed Rule, would mean that the government can no longer aid unions in their attempt to skim dues from precious Medicaid dollars, intended for the care of our loved ones.
In Rhode Island, about 7500 or so private home care workers are already represented by about 45 private-employer agencies as well as by a statewide association, the RI Partnership for Homecare. These service providers do not consider themselves to be government workers and most of these workers do NOT want to become a quasi-government employee.
The Rhode Island Partnership for Home Care, which oversees most of these private agencies, believes that government-run home care would destabilize the industry.It is also morally unjust that federal dollars, earmarked for home care services, could have dues automatically siphoned-off by state government unions from workers’ paychecks, then transferred to the unions, with some of the funds ending-up in the political campaign coffers of SEIU. If the proposed rule is enacted, it would be just and proper that 100% of the allocated federal funding for home care services should first go to the workers; and it would then be up to the unions to collect dues – on their own – from those who freely choose to join.Earlier this summer, after a major push by SEIU and other progressive activists, legislation that had been on the back burner was rammed through Rhode Island’s General Assembly and signed by the Governor. This new law could transfer control of the home care services industry from the private sector to the government and its union allies. This proposed rule, by removing the government as its potential partner, would create less of an incentive for SEIU to attempt to unionize this industry.
At the same time, the burden on state taxpayers would rise, as the government would surely provide frivolous and unnecessary benefits to allow unions to offer a more compelling reason to unionize.
The new law in Rhode Island seeks to lure home care workers, most of whom are now employed under a successfully operating private ‘agency’ system, to register with the government, becoming quasi-public employees, with their names and other personal information then to be turned over to SEIU labor bosses for the purposes of unionization efforts. A very similar approach was taken in 2013 to unionize the home child care industry; since then, union negotiated – and taxpayer funded – costs to support this industry have since risen dramatically.
This new Rhode Island law is a blatant money and power grab by unions that would crush a smoothly performing private agency system that is providing high quality home care to elderly, Medicaid, and other patients; and essentially turn over control of this industry to overly politicized and incompetent government bureaucrats. The training standards and strict oversight now required of nursing and other home care professionals would be greatly diminished.
Implementation of this proposed federal rule would remove the likelihood that government could insert itself between patients and their home care service providers.
The Center also points out how implementation of this proposed rule would create additional synergy with the direction that the nation is now heading, following landmark Janus decision, which would end the forced unionization and fee payments by public employees. As our country moves towards more freedom and less governmental control over our lives, Americans are experiencing renewed levels of prosperity. Enactment of this rule would maintain this momentum by keeping our state’s home care industry smoothly running under private management and away from the inefficiencies of the political elite and their special-interest allies.