Home and Community-Based Setting

The Centers for Medicare and Medicaid Services (CMS) released its long-awaited final rule that defines home and community-based setting.  The definition pertains to home and community-based settings across all Medicaid home and community-based services (HCBS) authorities: section 1915(k) Community First Choice, section 1915(i) State plan HCBS, and section 1915(c) HCBS Waivers.  Until the final rule is published in the Federal Register on January 16, a pre-publication version is available.  The rule will become effective March 17, 2014.  CMS has developed a website to provide information about the new rule, including an informational bulletin, a summary of key provisions in the new HCBS definition, fact sheets, questions and answers, and other related resources. CMS will be holding a series of informational webinars over the next several weeks. The dates for these webinars can be found on the website.

For currently approved 1915(c) waivers and 1915(i) state plans, states will need to evaluate the settings currently in their 1915(c) waivers and 1915(i) state plan programs and, if there are settings that do not meet the final regulation’s home and community-based settings requirements, work with CMS to develop a plan to bring their program into compliance. The public will have an opportunity to provide input on states’ transition plans. States will have up to one year to bring their HCBS settings into compliance.

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