On January 13, the Centers for Medicare & Medicaid Services (CMS) released a final rule detailing states' options to cover Home and Community-Based Services (HCBS) under Medicaid. Of key importance in the rule is the way "community" is defined across HCBS Medicaid authorities, as it designates which service settings are considered community-based and which are considered institutional. Services provided in institutional settings are not covered under HCBS services.
INARF members previously heard ANCOR's Diane McComb address this issue during the December 2013 Legislative & Critical Issues Forum, during which she shared ANCOR's position that HCBS language should not impede the ability of persons with disabilities to exercise choice in their living arrangements. The final HCBS rule reflected many of ANCOR's initial comments, including dropping the reference to disability specific housing as constituting an institutional setting.
In addition, CMS opted against mandating a separation between the housing provider and the services provider, though states may choose to make their own requirements. CMS will expect that people living in provider-controlled housing are afforded the same tenant rights as other citizens in their respective states. Of note is the fact that the definition of community-based applies to ALL HCBS services and supports, and is not limited to the residential setting. CMS plans to provide guidance on how this rule applies to day services in the coming weeks.
CMS has scheduled a public webinar to review the HCBS Final Rule for January 23rd from 1:00 p.m. to 3:00 p.m. (EST). A repeat of this webinar will be on January 30th at the same time. For information on how to participate in these webinars and other CMS resources related to the rule, please click here.
INARF and our industry partners will continue to analyze the rule and monitor related developments. Additional insight and information will be passed along, as it is available.