Transition Period Extended for Compliance with HCBS Criteria

May 2017~

CMS issued a Informational Bulletin providing additional clarity on provisions of the final regulation defining home and community-based service (HCBS) settings. The bulletin indicates that that states may take an additional three years to ensure compliance with criteria of a HCBS setting. The agency says this additional time “will be helpful to states to ensure compliance activities are collaborative, transparent and timely.”

HCBS federal standards adopted in 2014 mandate that Medicaid beneficiaries be offered opportunities to seek employment, interact with their communities, control their own money, among other things. The federal standards also ensures that enrollees in group homes should get more privacy and choices, including being able to live in places where non-disabled people live.

In its notice, CMS states that it recognizes “that compliance with the new regulations would be a complex process requiring a balancing of interests. As a result, CMS indicated that states were permitted to propose transition plans (i.e., Statewide Transition Plans) encompassing up to five years after the effective date of the regulations for settings reflected in existing state plans and waivers to come into compliance with the regulation.

In recognition of the significance of the reform efforts underway, CMS intends to continue to work with states on their transition plans for settings that were operating before March 17, 2014 to enable states to achieve compliance with the settings criteria beyond 2019. Consistent with the preamble language, states should continue progress in assessing existing operations and identifying milestones for compliance that result in final Statewide Transition Plan approval by March 17, 2019.”

CMS goes on to note that “in light of the difficult and complex nature of this task,” the transition period for states to demonstrate compliance with the HCBS settings criteria until March 17, 2022 for settings in which a transition period applies.

Matt Salo, executive director of the National Association of Medicaid Directors, applauded the delay.

“We have long been on record saying that the regulation was hopelessly unrealistic in its time frame,” he said. “Delaying it actually helps consumers because the underlying regulation was going to push too many changes too fast into a system that wasn’t ready.”

Source(s): Medicaid.gov; Kaiser Health News; Managed Care Magazine; Physician’s Weekly;