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# CMS spells out how states must report direct care worker pay
- URL: https://thevoiceofenablingtechnology.pmbofficial.com/live-wire/cms-spells-out-how-states-must-report-direct-care-worker-pay/
- Published: 2026-10-09T13:00:00.000Z
- Updated: 2026-10-25T21:06:24.000Z
- Description: New CMS guidance tells states how to report the share of Medicaid home care payments that goes to direct care worker pay.
- Author: The Live Wire
- Tags: #live-wire, #wire-policy

The Centers for Medicare & Medicaid Services [issued guidance to states on Oct. 9](https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD26005.pdf?ref=thevoiceofenablingtechnology.pmbofficial.com) explaining how to report the share of Medicaid home care payments that go to direct care worker compensation.

**What's in it:** [State Medicaid Director Letter 26-005](https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD26005.pdf?ref=thevoiceofenablingtechnology.pmbofficial.com) covers homemaker, home health aide, personal care and habilitation services delivered through 1915(c), (i), (j) and (k) authorities and 1115 demonstrations. [States must report annually starting July 9, 2028](https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD26005.pdf?ref=thevoiceofenablingtechnology.pmbofficial.com), and show readiness by July 9, 2027.

**Why it matters:** For the first time, states will publicly show how much home and community-based services money reaches the workers who deliver care. The data could inform rate setting and workforce policy.

**Who it affects:** State Medicaid agencies, HCBS providers, direct support professionals and home care aides, and the people supported who depend on a stable workforce.

**What's next:** Providers should expect states to request compensation data well ahead of the 2028 deadline.

**Source:** CMS, SMD# 26-005, Oct. 9, 2026: [https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD26005.pdf](https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SMD26005.pdf?ref=thevoiceofenablingtechnology.pmbofficial.com)