Model Comment Letter on Medicaid Access Rule

Background and Instructions

HHAC and NAHC encourage our members to submit comments on the proposed Medicaid Access Rule. This rule includes a wide range of changes to Medicaid-funded homecare and, most importantly, includes a provision that would require 80% of all Medicaid payments for personal care, home health aide, and homemaker services to be spent on compensation to direct care workers. NAHC is strongly opposed to this provision and hopes that CMS reverses course on this aspect of the rule.

The deadline for submitting comments is July 3rd.

If you have any questions or require assistance with submitting comments, please contact Damon Terzaghi, NAHC’s Director of Medicaid Advocacy, at [email protected].

Helpful links

  • The full rule is available at: https://www.federalregister.gov/documents/2023/05/03/2023-08959/medicaid-program-ensuring-access-to-medicaid-services
  • The NAHC Summary and Analysis is available at: https://report.nahc.org/nahc-analysis-new-proposed-cms-medicaid-access-rule/
  • Comments may be submitted online at: https://www.regulations.gov/commenton/CMS-2023-0070-0001

Suggestions for Writing Comments

CMS gives specific weight to individualized comments instead of form-letters, so we strongly encourage you to personalize your message. According to the Regulations.gov commenting tips, “A single, well-supported comment may carry more weight than a thousand form letters.”

Additional recommendations from Regulations.gov include:

  • Read and understand the regulatory document you are commenting on
  • Feel free to reach out to the agency with questions
  • Be concise but support your claims
  • Base your justification on sound reasoning, scientific evidence, and/or how you will be impacted
  • Address trade-offs and opposing views in your comment
  • There is no minimum or maximum length for an effective comment

Below, we provide a suggested format and topics to stress, and we also highlight areas that can be elaborated upon or strengthened with your own personal and organizational perspective. There is no “one way” to submit comments; however, we recommend that you include specific information and data about the impact of the rule wherever possible. Overall, the most important thing you can do is to tell your story and explain how the proposed changes would be detrimental both to your employees and the people you serve.

We also encourage you to change the format of the document below to match your usual style. This can include adding your own letterhead, changing fonts, or doing other cosmetic changes to show that it is reflective of your own organization.

Submitting the Comments

When you are ready to submit your comments, we recommend that you:

  • Double check for errors, typos, and lingering issues that may come from editing the template.
  • Remove all of the instructions pages and areas highlighted in the document.
  • Include your own signature, title, organization, and date.
  • Save the document as a PDF.

To formally submit your comments:

  • Go to: https://www.regulations.gov/commenton/CMS-2023-0070-0001
  • In the box titled “Comment,” enter “Please see attached document.”
  • Upload your PDF document to the site.
  • Provide your e-mail address.
  • Select “an Organization” from the “tell us about yourself” options.
  • Make sure to check the “I am not a robot box.”
  • Hit submit.

After Submission

Please send a copy of your comment letter to Damon Terzaghi, NAHC’s Director of Medicaid Advocacy, at [email protected].

Click for customizable form letter