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Home & Community Based Services Guidance & Additional Resources

The Centers for Medicaid and CHIP Services (CMCS) issues technical assistance as part of the state-federal partnership in administering the Medicaid programs. We use this guidance, in the form of letters to State Medicaid Directors, Informational Bulletins, Issue Briefs, and Frequently Asked Questions, to communicate with states and other stakeholders regarding operational issues related to home and community based services (HCBS).

Technical assistance is available from CMS to assist state Medicaid agencies in developing, enhancing, implementing, and evaluating HCBS.

Proposed Medicaid Access Rule – HCBS Provisions

CMS published a Notice of Proposed Rulemaking (NPRM) titled, “Ensuring Access to Medicaid Services (CMS 2442-P)” on April 27, 2023. The proposed rule takes a comprehensive approach to improving access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee for service and managed care delivery systems, including in HCBS programs. These proposed improvements seek to increase transparency and accountability, standardize data and monitoring, and create opportunities for states to promote active beneficiary engagement in their Medicaid programs, with the goal of improving access to care. Please submit any comments on this proposed rule by July 3, 2023.  Additional information:

HCBS Training Series

The HCBS Training Page provides web-based training presentations and other materials on a variety of HCBS topics to ensure that CMS, state agencies and other stakeholders have a clear understanding of HCBS programs. These webinars have focused on a variety of topics such as Home and Community Based settings requirements, the Heightened Scrutiny Process, Fiscal Integrity with a focus on Personal Care Services, and Conflict of Interest.