CMS Opens Public Comment on Proposed 2028 HCBS Quality Measure Set

Home and Community-Based Services; Assisted Living; ID/DD
 
The Centers for Medicare & Medicaid Services (CMS) has officially opened the public comment period for the proposed 2028 Home and Community-Based Services (HCBS) Quality Measure Set, marking an important milestone in the implementation of the HCBS Access Rule. 

A formal notice was published in the Federal Register this week, and comments will be accepted for 30 days, with a deadline of May 28, 2026. CMS also released a supplemental PDF notification​ outlining additional context for stakeholders. 

What’s Being Proposed 

CMS is proposing a total of 26 quality measures, including: 

  • 23 mandatory measures, such as: 

    • Choosing the Services That Matter to You Composite 

    • Personal Safety & Respect Composite 

    • Transportation to Medical Appointments Composite 

    • LTSS comprehensive assessment and update 

    • Measures addressing community inclusion, personal safety, person-centered planning, and freedom from abuse and neglect 

  • Three voluntary measures, including: 

    • Reassessment following inpatient discharge 

    • Screening and planning to prevent falls 

    • Optional HCBS CAHPS, NCI, or POM measures not otherwise included 

Data collection would be limited to HCBS waiver participants and gathered through HCBS case managers or participant surveys (see Table 4 of the provisions of the notice with comment period). Per the HCBS Access Rule, implementation of the mandatory measures is targeted for 2028. 

Why It Matters 

The Federal Register is now live, and CMS is actively accepting comments. This is a critical opportunity for providers, advocates, and other stakeholders to weigh in on feasibility, burden, and alignment with person-centered care goals. 

Stakeholder input during this short comment period will shape how HCBS quality is measured nationwide. Now is the time to review the proposal and submit feedback.  

NCAL would love to hear from you on how the proposed 2028 HCBS Quality Measure Set may impact you. Please direct your comments to ncal@ncal.org by May 15, 2026.