|
The final rule supports enhancement of the quality of home and community-based services (HCBS), adds protections for individuals receiving services, and provides additional flexibility to states that participate in the various Medicaid programs authorized under section 1915 of the Social Security Act (the Act). Highlights of the final home and community-based services rule include:
• Provides implementing regulations for section 1915(i) State Plan HCBS, including new flexibilities enacted under the Affordable Care Act to offer expanded HCBS and to target services to specific populations;
• Defines and describes the requirements for home and community-based settings appropriate for the provision of HCBS under the Section 1915(c) HCBS waiver, 1915(i) State Plan HCBS and 1915(k) (Community First Choice) authorities;
• Defines person-centered planning requirements across the 1915(c) and 1915(i) authorities;
• Provides states with the option to combine coverage for multiple target populations into one waiver under Section 1915(c), to facilitate streamlined administration of 1915(c) HCBS waivers and to facilitate use of waiver design that focuses on functional needs.
• Allows states to use a five-year renewal cycle to align concurrent waivers and state plan amendments that serve individuals eligible for both Medicaid and Medicare (dual eligibles), such as 1915(b) and 1915(c).
• Provides CMS with additional compliance options beyond waiver termination for 1915(c) HCBS waiver programs.
• Provides an additional exception to the general requirement that payment for services under a state plan must be made directly to the individual practitioner when the state is the primary source of employment for a class of individual practitioners.
(FAQ9784)
|
