The Home and Community Based Services (HCBS) Final Rule, released earlier this year, created new requirements for the types of settings eligible for reimbursement for Medicaid HCBS delivered under sections 1915(c), 1915(i), and 1915(k) of the Medicaid statute. To assist stakeholders in understanding the settings requirements of the final rule, the Centers for Medicare and Medicaid Services (CMS) recently released a Home and Community Based (HCB) Settings Toolkit. The toolkit is designed to assist State Medicaid Agencies, Operating Agencies, and other stakeholders in complying with the new HCBS settings requirements.
The toolkit, which provides information on residential settings requirements, includes:
- summary of fully compliant and excluded HCB settings;
- drawings illustrating the heightened scrutiny process for the HCBS waiver and compliance;
- technical guidance on regulatory language about settings that isolate; and
- exploratory questions to assist in assessing residential settings.
CMS is also working to develop guidance for states about HCBS compliant non-residential settings; although it is hoped that this toolkit will provide information about traits to consider when assessing both residential and non-residential settings.
Read about TAC's work on Community Integration.