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 These resources are copied below. Visit 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

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.

December 15, 2016: Medicaid Beneficiaries in HCBS who Exhibit Unsafe Wandering or Exit-Seeking Behavior

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:

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.