CMS Released Medicaid Rules for Home and Community Based Services (HCBS)

Biden administration rules impacting Medicaid-funded skilled nursing, assisted living and enhanced services facilities were finalized and released by CMS this week. For home and community-based care settings in Washington, yesterday’s HCBS Ensuring Access to Medicaid Services Rule applies.

States are now charged with implementation of the new standard which includes requirements to:

• Create a Medicaid Advisory Committee (MAC) and Beneficiary Advisory Council (BAC);
• Create grievance and incident management systems;
• Develop reporting requirements on a HCBS quality measure sets (mandatory and voluntary measures previously outlined by CMS); and
• Provide transparency on website information and payment rates.

Additionally, the rule outlines HCBS Payment Adequacy, a section that requires providers to pay 80 percent of reimbursement for homemaker, home health aide, and personal care services for employee wages. Because all states have a different methodology for reimbursement, each one will need to work with the state agency to identify the impact this section of the rule has on our HCBS providers, if any.

We will provide additional information on implementation as it becomes available.

Resources:

• HCBS final rule 
• Chart outlining the applicability dates for all regulatory changes