Guidance from Center for Medicare & Medicaid Services (CMS)
The Centers for Medicare and Medicaid Services have provided fact sheets, webinar slides, informational bulletins, and toolkits on Medicaid.gov/hcbs. These resources are copied below. Visit Medicaid.gov/hcbs for the most up-to-date information from CMS on the HCBS settings rule.
September 11, 2019: HCBS Planned Construction of Presumed Institutional Settings
March 22, 2019: Heightened Scrutiny Reviews Guidance
- Statement from HCBS Advocacy Coalition on CMS Heightened Scrutiny Guidance
- PowerPoint Slides from Training from CMS on Heightened Scrutiny Guidance
May 9, 2017: Extension of Transition Period for Compliance with Home and Community Based Settings Criteria. Please note this extension is provided for compliance of settings, which is now extended to March 2022. The deadline for final statewide transition plan approval is still March 2019.
CMS Settings Requirements Compliance Toolkit
CMCS is pleased to share with State Medicaid Agencies, Operating Agencies, and other stakeholders a Home and Community-Based Settings Toolkit to assist states develop Home and Community-Based 1915(c) waiver and 1915(i) SPA amendment or renewal application(s) to comply with new requirements in the recently published Home and Community Based Services’ (HCBS) regulations. The toolkit includes:
- A summary of the regulatory requirements of fully compliant HCB settings and those settings that are excluded.
- Schematic drawings of the heightened scrutiny process as a part of the regular waiver life cycle and the HCBS 1915(c) compliance flowchart. Heightened Scrutiny Questions and Answer (June 26, 2015)
- Additional technical guidance on regulatory language regarding settings that isolate.
- Guidance on the implementation of the Community First Choice State Plan Option (December 30, 2016)
- Exploratory questions that may assist states in the assessment of:
- Questions and Answers Regarding Home and Community-Based Settings
- Statewide Transition Plan Toolkit for Alignment with HCB Settings Regulation Requirements Suggestions for alternative approaches and considerations for states as they prepare and submit Statewide Transition Plans for the new federal requirements for residential and non-residential home and community-based settings. The regulatory requirements can be found at 42 CFR 441.301(c)(4)(5) and 441.710(a)(1)(2).
- HCBS Basic Element Review Tool for Statewide Transition Plans and HCBS Content Review Tool for Statewide Transition Plans
- Frequently Asked Questions Regarding the Heightened Scrutiny Review Process and Other Home and Community-Based Settings Information
- Frequently Asked Questions on Planned Construction and Person-Centered Planning Requirements
Final Regulation Announcement
In 2014, the final Home and Community-Based Services regulations set forth new requirements for several Medicaid authorities under which states may provide home and community-based long-term services and supports. The regulations enhance the quality of HCBS and provide additional protections to individuals that receive services under these Medicaid authorities.
- Final Regulation: 1915(i) State Plan HCBS, 5-Year Period for Waivers, Provider Payment Reassignment, Setting Requirements for Community First Choice, and 1915(c) HCBS Waivers – CMS-2249-F/CMS-2296-F
- Informational Bulletin – Final regulations for HCBS provided under Medicaid’s 1915(c), 1915(i) and 1915(k) authorities
- Press Release – Final regulations for HCBS provided under Medicaid’s 1915(c), 1915(i) and 1915(k) authorities
- Fact Sheets Regarding Final Regulation CMS-2249-F/CMS-2296-F
- Key Provisions of the Final HCBS Rule