Guidance and Resources: Home and Community Based Services (HCBS) Provisions

CMS is issuing guidance and other resources to support the implementation of each of the HCBS provisions in the Access Final Rule.

• Fee-for-Service HCBS Grievance System
  • CMCS CIB  - Exercise of Enforcement Discretion for Requirements for a Medicaid Fee-For-Service Grievance System for Home and Community-Based Services Until December 2027 – Released February 2026
• Direct Care Worker Compensation Reporting Requirement  
  • SMD#26-005 - Direct Care Worker Compensation (Home and Community-Based Services Payment Adequacy) Reporting Requirement – Released October 9, 2026
  • Direct Care Worker Compensation (Home and Community-Based Services Payment Adequacy) Reporting Requirement Technical Specifications – Released October 9, 2026

Note: This provision was referred to in the Access Final Rule as the “HCBS payment adequacy reporting” requirement. In this guidance, CMS refers to it as the “direct care worker compensation reporting” requirement.

For questions about the direct care worker compensation reporting requirement, email DCWreporting@cms.hhs.gov. 

For any other questions regarding the HCBS provisions of the Access Final Rule, email HCBSAccessRule@cms.hhs.gov.