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CMS Proposes HCBS Waiver Rules

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CMS Proposes HCBS Waiver Rules

April 18, 2011

The Centers for Medicare and Medicaid Services (CMS) proposed new rules on April 14that include significant provisions affecting 1915(c) Home and Community-Based Services (HCBS) waivers contemplated by the agency for the past three years. These waivers were included in a CMS “white paper” on which ANCOR was invited to comment and a previous Advance Notice of Intention to Propose Rules with comment period to which ANCOR provided comments.


The long-awaited rules give states new flexibility for their 1915(c) programs, allowing states to seek waivers to help multiple populations, which can include seniors and/or individuals with different types of disabilities.The proposed rules are intended to reduce administrative barriers that require states to select a single target population such as individuals with intellectual disabilities and developmental disabilities and instead choose three waiver targeting groups.


The new rules also include provisions conveying expectations for person-centered expectations for person-centered plans, characteristics for settings that are not community-based, timing for waiver amendments, and requirements for public input for waiver modifications to HCBS waivers and service rates. The rules will also allow individuals to participate in the design of their own array of services and supports, including such things as personal care and respite services for caregivers.


Comments are due June 14, 2011. ANCOR will work with its committee structure in providing comments on this important regulation.The proposed regulation, CMS-2296-P, is available here.