Federal rollbacks remove nursing-home and home-care rules as Medicare A.I. pilot begins

The federal government has rescinded two rules aimed at improving care for older Americans and launched an A.I.-driven prior authorization pilot in traditional Medicare, moves that advocates say will reshape long-term care and coverage. On nursing homes, the Biden administration had backed a 2023 Medicare regulation that would have required at least 3.48 hours of care from nurses and aides per resident per day and a registered nurse on site 24/7; C.M.S.

adopted the standards in 2024 but industry lawsuits and two federal district court rulings blocked most provisions. In July, Congress barred Medicare from implementing the standards before 2034 as part of a budget reconciliation bill, and C.M.S. repealed the rule last month so it never took effect.

Supporters had celebrated the rule as a federal floor for understaffed facilities; critics argued it would force homes to hire caregivers they said do not exist. The Labor Department also announced in July that it would return to a 1975 interpretation excluding home care workers from the Fair Labor Standards Act and stop enforcing a 2013 rule that had entitled many home care workers to the minimum wage, overtime and travel pay.

The 2013 rule had led to hundreds of complaints and a Government Accountability Office finding that 87 percent alleged violations; advocacy groups say agencies have paid about $158 million in back wages since then.

Key Topics

Health, Medicare, Nursing Homes, Home Care Workers, Flsa, Wiser