CMS Delays HCBS Rule for Three Years

CMS Delays HCBS Rule for Three Years

CMS Delays HCBS Rule for Three Years

CMS Delays HCBS Rule for Three Years

CMS delays HCBS rule for three years. This provides an additional three years to comply with the home and community based services for Medicaid beneficiaries.

The new time line was announced in an informational bulletin from Brian Neale, director of the agency’s Center for Medicaid and Chip services moves the deadline from March 17,2019 to March 17, 2022.

In 2014 new reimbursement rules for home and community based settings was established with the goal of having beneficiaries be able to receive services that would be more easily integrated into community based programs rather than skilled nursing facilities. Numerous assisted living facilities have provided home and community based services to residents through a waiver. The waiver does not permit services to be provided in out building or isolated settings that do not permit the beneficiary a community like setting. These programs must meet a much higher standard of proof before becoming eligible for the waiver.

Health and Human Services Secretary Tom Price, M.D., and CMS Administrator Seema Verma, MPH notified governors that CMS was considering lengthening the five year time frame that states were originally given to comply with the final rule. The march letter delaying implementation was not a complete surprise to the states.

State have been advised to continue to develop transition plans necessary to receive reimbursement under the new criteria. In addition they must develop qualifications for other senior living settings to qualify for home and community based services. To date only Tennessee has received final approval for its transition plan. Twenty six other states have received initial approval of their plans. The initial approval required them to take public comment, meet input and summary requirement. They have not met systemic and site specific assessments necessary for final approval.

CMS had determined that the difficult and complex nature of this task could not be completed properly by the March 2019. CMS realized that it would be better to meet the appropriated standards throughout the country then to implement a program that might not meet the stated needs of this most vulnerable population.

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