Information on 2024 Reimbursement Rate Increase
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Background:
- Last year, the Illinois legislature passed an Omnibus Medicaid package that included a 20% rate increase for pediatric private duty nursing beginning 1/1/2024.
- The federal government approved this reimbursement rate increase through both a state plan amendment and an amendment to the MFTD Waiver.
- This reimbursement rate increase applies to:
- All children under 21 not in a waiver receiving private duty nursing through the regular Medicaid state plan (non-waiver nursing)
- All children under 21 in the MFTD Waiver receiving private duty nursing through the regular Medicaid state plan
- All individuals over 21 receiving private duty nursing through the MFTD Waiver
- Individuals of any age in the MFTD Waiver receiving Respite Care from an RN, LPN, or CNA
- The 2024 Home Health Fee schedule outlines the new rates, which are:
- RN: $54 per hour
- LPN: $45 per hour
- CNA: $30 per hour
What is a Reimbursement Rate Increase?
- A reimbursement rate increase means that there is an increase in the amount of money reimbursed per hour to nursing agencies. It is NOT a direct pay raise to nurses.
- Nursing agencies are permitted to set their own pay rates and choose to pay benefits or not. Each agency can choose how much they want to increase nurse pay.
- Agencies may pay nurses different rates depending on a wide range of factors including location of agency, nurse experience, complexity of a case, payors on a case, and other benefits provided.
What Families Can Do:
- Nursing agencies should have been notified about the reimbursement rate increase, but families can share any of the information provided in this document with their agencies.
- Nurses may or may not have been notified about the reimbursement rate increase. Please share the documents linked above or this information sheet with your nurses. Nurses should be encouraged to renegotiate their pay rates for 2024.
- Encourage your nursing agency to adopt the MFTD Waiver Families Minimum Recommended Nurse Pay Rates listed below, which use a standardized pass-through rate to calculate direct pay.
MFTD Waiver Families Minimum Recommended Nurse Pay Rates:
We recommend that agencies pay nurses a minimum of 75-80% of the hourly reimbursed rate in either direct pay or pay plus benefits. This percentage is based on other Illinois programs with set pass-through percentages and pending federal recommendations.
For direct pay, the minimum recommended rate range is:
- RN: $40.50 to $43.20 per hour
- LPN: $33.75 to $36 per hour
- CNA: $22.50 to $24 per hour
If direct benefits are provided, rates may be reduced by the value of benefits.