Home & Community Based Services Final Regulation

The final Home and Community-Based Services (HCBS) 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
    • Overview of Regulation
    • 1915(c): Changes to HCBS Waiver Program
    • 1915(i): Key Provisions for HCBS State Plan Option
    • Summary of Key Provisions of the HCBS Settings Final Rule
    • HCBS Final Rule Webinar Presentation Download
    • Final Rule: Questions and Answers

Extension of Transition Period for Compliance with Home & Community Based Settings Criteria

A State Medicaid Director Letter was released on July 14, 2020, indicating that the transition period for compliance with home and community based settings criteria is extended until March 17, 2023.

An Informational Bulletin was released on May 9, 2017, indicating that the transition period for compliance with home and community based settings criteria is extended until March 17, 2022.

Home and Community-Based Services Final Rule Update: Final Statewide Transition Plan Submissions, Settings Criteria Not Impacted by the COVID-19 PHE, and Requests from States for Corrective Action Plans

A PowerPoint Slide Deck was released on May 24, 2022, sharing an updated strategy for implementation of the home and community-based settings regulation, developed in partnership with the Administration for Community Living (ACL), that aligns the focus of federal support and state compliance activities with the realities of the direct-service workforce crisis exacerbated by the COVID-19 public health emergency (PHE).  CMS and ACL believe this strategy will ensure implementation of important regulatory criteria related to beneficiary rights in the short-term, with sustained state and provider efforts to fully implement all other settings criteria.

• Tuesday, May 24, 2022 CMS COVID-19 Medicaid & CHIP COVID-19  All-State Call (ZIP, 9.84 MB)
  • All-State Medicaid & CHIP Presentation (PDF, 789.65 KB)