CMS Fully Implements HCBS Final Rule

Assisted Living; CMS; Regulations

Eight years ago, the Centers for Medicare and Medicaid Services (CMS) introduced the Home and Community-Based Services (HCBS) final rule on settings regulation, and on March 17, 2023, the rule was fully implemented.   

CMS and the Administration for
Community Living (ACL) issued a joint statement stating, “Today represents a key milestone in years of systems change by states, service providers, disability and aging advocates, and, importantly, people receiving HCBS and their families.” 

CMS set forth regulations in 2014 establishing standards for settings who accept Medicaid waiver reimbursement. The federal regulations focus on community integration, individual choice and privacy, and other factors that relate to an individual’s experience of the setting as being home-like and not institution-like. These regulations set a floor for Medicaid reimbursement and states were charged with developing a statewide transition plan (STP) to comply with the regulations.   

Any state who has not received final approval on its STP to date has submitted a corrective action plan (CAP) outlining how those states will continue to work with CMS and HCBS providers in full compliance.   

You can find a list of states, their status with compliance and CMS communication here.