Federal Reimbursement for Elder and Aging Services

 With growing numbers of older adults living independently, states must consider the financing for programs that support this population as the needs continue to expand.

PCG is ready to assist in identifying programmatic and administrative expenditures that qualify for Medicaid reimbursement in Home and Community Based Services programs for elderly and aging residents. PCG has a methodology to claim Medicaid Administrative Case Management (ACM) and other administrative costs related to state and local programs that assist elderly residents to remain in their own homes and out of expensive assisted living and nursing home settings.

Call on PCG to:

• Analyze your elder home and community-based program to determine how to obtain Medicaid reimbursement for your aging programs, even if they are already operating under a HCBS waiver;
• Configure a state-of-the art random moment time study (RMTS) to identify the applicable time spent performing ACM-allowable and Medicaid Administrative services;
• Identify other areas where other federal reimbursement could be sought.

PCG Expertise
PCG has extensive knowledge and experience regarding revenue maximization avenues for public agencies to consider and pursue for specialized populations of vulnerable citizens. Our consultants have worked with many states to identify potential funding opportunities that can improve services, develop or complement efficient business processes, and plan for future growth and unmet need. PCG understands federal policy and regulations and can assist a state in maneuvering through the development of a comprehensive system of care that meets current needs and requires available funding.

Among our projects:

• For the Massachusetts Executive Office of Elder Affairs, PCG successfully implemented a Medicaid ACM program that provides over $3 million in annual reimbursement for case management activities related to its Home Care program.

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