HCBS Final Rule Deadlines Approaching

Assisted Living; CMS; Regulations

The March 17, 2023, transition period deadline for full state compliance with the Home and Community-Based Services (HCBS) Final Regulation, effective March 17, 2014, is quickly approaching. Although there has been much push back to the Center for Medicare and Medicaid Services (CMS) that states and providers have not had ample time to prepare due to the COVID-19 pandemic and workforce shortages, CMS is forging ahead and outlined an aggressive timeline earlier this year to help states and providers meet that deadline.   

The timeline outlined by CMS includes:  
  • ​​By December 1, 2022, states should submit to CMS any request for a Corrective Action Plan (CAP). A CAP should include: 
    • ​Information on which criteria the state will need extra time to ensure full provider compliance; 
    • ​The state’s efforts to bring providers into compliance with those criteria, and the PHE-related impacts that created barriers to compliance; and  ​
    • The state’s plan to overcome encountered barriers, and the time needed to do so. 

  • By January 1, 2023, states should have the following information, which may be in the state’s Statewide Transition Plan (STP), submitted to CMS: 
    • Description of how the state’s oversight systems (licensure and certification standards, provider manuals, person-centered plan monitoring by case managers, etc.) have been modified to embed the regulatory criteria into ongoing operations; ​
    • ​Description of how the state assesses providers for initial compliance and conducts ongoing monitoring for continued compliance; and  
    • Description of a beneficiary’s recourse to notify the state of provider noncompliance (grievance process, notification of case manager, etc.) and how the state will address beneficiary feedback. 

Per CMS, the multi-faceted approach outlined contains the following components, in order to continue federal reimbursement of HCBS beyond the transition period:  

  • States must receive final STP approval  
  • States and providers must be in compliance with all settings criteria NOT directly impacted by PHE disruptions, including PHE-related workforce challenges  
  • Time-limited corrective action plans (CAPs) are available to states to authorize additional time to achieve full compliance with settings criteria that are directly impacted by PHE disruptions, when states document the efforts to meet these requirements to the fullest extent possible and are in compliance with all other settings criteria.