CMS Issues Final Rule on Medicaid Home- and Community-Based Services


On January 10, 2014, CMS issued its final rule governing Medicaid’s home- and community-based services programs.  According to CMS, the final rule allows states more flexibility to offer services to elderly and disabled Medicaid beneficiaries.  Key provisions of the rule include, among others:

  • A five-year approval or renewal period for certain Medicaid waivers, when they provide medical assistance for those eligible for both Medicaid and Medicare;
  • Certain exceptions to the general requirement that payment for services under a state plan be made directly to the individual practitioner;
  • A requirement that attendant services and support must be provided in a home and community-based setting (does not include nursing facilities, institutions for mental diseases, or intermediate care facilities for individuals with intellectual disabilities); and
  • Several key changes to the regulations implementing Medicaid 1915(c) HCBS waivers, allowing states to offer services without first obtaining a waiver from CMS.

 The final rule was published in the Jan. 16, 2014 Federal Register (available here), and will be effective March 17, 2014. 

Reporter, Katy Lucas, Atlanta, +1 404 572 2822,

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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