The Centers for Medicare & Medicaid Services (CMS) have issued regulations that define the settings in which it is permissible for states to pay for Medicaid Home- and Community-Based Services (HCBS). The purpose of these regulations is to ensure that individuals receive Medicaid HCBS in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services in the community, to the same degree as individuals who do not receive HCBS.
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Information Resources
- March 2019 CMS guidance on the Heightened Scrutiny Review Process
- Case Management (CM) Webinar FAQ (webinar of March 22, 2017)
- Home- and Community-Based Services (HCBS) Residential Setting Member Assessment
- Home- and Community-Based Services (HCBS) Nonresidential Setting Assessment
- HCBS Setting Requirements Heightened Scrutiny Questions and Answers (Q&A)
- HCBS Final Regulations 42 CFR Part 441: Questions and answers regarding Home- and Community-Based Services (HCBS) Settings
- HCBS Settings Requirements
- Guidance on settings that have the effect of isolating individuals receiving Home- and Community-Based Services (HCBS) from the broader community
- Exploratory Questions to Assist States in Assessment of Residential Settings
- Exploratory Questions to Assist States in Assessment of Non-Residential Home- and Community-Based Service (HCBS) Settings
Other relevant documents on the new HCBS regulations
- Responses to Public Comments:
- Presentation Slides from Webinars (November 2014)
- HCBS Settings Analysis (August 2014)
- Iowa Exploratory Questions (October 2014)
- Iowa Settings That Isolate (August 2014)
- HCBS Settings Transition White Paper (April 2014)
- Presentation Slides on the Public Comments Meeting (April 2014)
Home- and Community-Based Services for Members Webpage
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