CMS Extends Transition Period for Home and Community-Based Settings Criteria

Added on May 18, 2017

CMS Extends Transition Period for States to Comply with Home and Community-Based Settings Criteria
From Industry Edge May 2017

The Centers for Medicare & Medicaid Services (CMS) is giving states until March 17, 2022 to begin implementing Medicaid programs that meet the home and community-based services (HCBS) settings requirements for settings operating before March 17, 2014.

The requirements were developed by the Obama administration in 2014 in an effort to provide opportunities for Medicaid beneficiaries to receive services in their own home or community rather than institutions or other isolated settings. The programs serve a variety of targeted population groups, such as people with intellectual or developmental disabilities, physical disabilities and/or mental illnesses. Originally, the programs were scheduled to take effect March 17, 2019. CMS said the extension is in response to states’ requests for more time to demonstrate compliance with the regulatory requirements and “ensure compliance activities are collaborative, transparent and timely.”

According to CMS, the rule requires that states develop plans that provide opportunities for Medicaid enrollees to seek employment, control their own money, engage in community life, and enjoy more privacy as well as more housing choices that include group homes and other residential settings regardless of whether the housing options are devoted to serving disabled persons. As of press time, Tennessee was the only state whose implementation plan had been approved by CMS. States have until March 17, 2019 to win implementation plan approval.

“Medicaid programs are strongest when states have time to engage with beneficiaries and their families to ensure these programs fit their choices and needs,” said CMS Administrator Seema Verma. “Extending the HCBS compliance period by three years allows states to work more closely with those they serve, so they can increase the quality of care and minimize the potential for unnecessary disruption in services.”

More information is available on the Medicaid.gov website.