Use this page to find official resources and information from the federal government regarding the rule.
Centers for Medicare and Medicaid Services
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.
Final Regulation Announcement
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 (January 10, 2014)
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
Administration on Community Living three-part Setting Rule Webinar Series
HCBS Settings Webinar Series: Promising Practices in State Approaches to Implementing Federal Criteria. ACL, in partnership with the Centers for Medicare & Medicaid Services (CMS) and other national partners, is hosting a three-part technical assistance webinar series highlighting innovative strategies and approaches states are taking to effectively implement the federal settings criteria for home and community-based services (HCBS). The webinar series is intended to help ACL’s networks, partners, and external stakeholders identify strategic ways to engage in their state’s ongoing HCBS systems transformation efforts.
Slide deck from part one of this 3 part webinar series held on November 8, 2018: Innovative State Approaches to Promoting Compliance with the Federal HCBS Settings Criteria
HHS-Wide Guidance on Person-Centered Planning and Self Direction
On June 6, the Secretary of Health and Human Services issued guidance regarding person-centered planning and self-direction. The guidance is applicable across HHS offices, including in HCBS.
- Read the Administration for Community Living blog post: Person-Centered Planning and Self-Direction regarding the HSS Guidance on Implementing Section 2402(a) of the Affordable Care Act.
- Informational Bulletin on 1915(c) Employment and Employment Related Services
- Modifications to Quality Measures and Reporting in §1915(c) Home and Community-Based Waivers
- State Medicaid Director’s Letter- August 2010 – Improving Access to Home and Community-Based Services
- List of 1915(c) Waiver Renewals Expected Through April 2015
Office of Disability Employment Programs
Archived Webinar: Implications of HCBS Final Rule on Non Residential Settings
The U.S. Department of Labor’s Office of Disability Employment Policy, in collaboration with the Disability & Elderly Public Health Group within the Centers for Medicare and Medicaid Services, presented this webinar for state policy-makers and disability policy stakeholders to discuss recent Federal policy guidance issued by CMS. The webinars included a brief presentation by CMS followed by a highly interactive dialogue to address questions on the impact of these Federal policy developments on state systems-change efforts related to improving integrated employment and community-based engagement of citizens with significant disabilities.