Verma, Price support extending time frame for compliance with HCBS settings rule


The heads of the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) have issued a joint letter to U.S. governors saying they support extending the time frame for compliance with the home and community-based services (HCBS) settings rule.

CMS Administrator Seema Verma and HHS Secretary Tom Price said in the letter that they support including more state involvement in assessment of settings compliance.

LeadingAge says the timeframe for compliance (the final implementation date for the HCBS Settings rule is March 2019) is not the main issue. LeadingAge says it looks forward to see more state involvement in the process, but it remains concerned that without practical, realistic guidance from CMS on the implementation of the HCBS settings rule for all Medicaid populations, especially vulnerable older adults , states may continue to implement policies that ultimately reduce access to HCBS. Those include:

  • Closing or limiting Memory Care Assisted Living Centers, adult day services centers and assisted living centers in rural, frontier and medically underserved areas that may be the only qualified provider to offer home and community based services and case management
  • Considering closing or limiting quality co-located Assisted Living Centers and adult day services centers not to be home and community based services just because of their location
  • Implementing heightened scrutiny and remediation policies that are barriers for Medicaid HCBS providers that have limited resources to implement costly new regulatory requirements

LeadingAge says it thanks the the agency leaders for their commitment and looks forward to meeting with them to improve access to quality, person-centered home and community-based services for older adults.