Health Reform WK-EDGE States get 3 more years to propose home- and community-based transition plans
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Thursday, May 18, 2017

States get 3 more years to propose home- and community-based transition plans

By Sarah E. Baumann, J.D.

Following through on statements made in a March 2017 letter to state governors, CMS is granting states more time to comply with a 2014 Final rule regulating expanded access to home- and community-based services (HCBS). In a Centers for Medicaid & CHIP Services (CMCS) Information Bulletin, the agency announced that it will allow give states until March 17, 2022, to demonstrate compliance with HCBS requirements for settings in which a transition period applies. The 2014 Final rule permitted states to propose transition plans up to five years after the effective date of regulations—or March 17, 2019—for compliance with regulations governing services provided under Social Security Act (SSA) sections 1915(c), 1915(i) and 1915(k) (CMCS Informational Bulletin, May 9, 2017).

The 2014 Final rule (79 FR 2948, January 16, 2014) amended Medicaid regulations pursuant to section 2601 of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), which added section 1915(h)(2) to the Social Security Act to provide authority for a five-year duration for certain demonstration projects or waivers under sections 1115, 1915(b), (c), or (d) of the SSA that provide medical assistance to individuals dually eligible for Medicare and Medicaid, at the HHS Secretary’s discretion (see Final rule sets requirements for expanded home and community based services, January 16, 2014). CMS permitted a five-year transition period, if the state can support the need for such a period of time," after comments on the Proposed rule reflected the complexity of the compliance process.

CMS Administrator Verma commented, "Medicaid programs are strongest when states have time to engage with beneficiaries and their families to ensure these programs fit their choices and needs," and suggested that the extension "allows states to work more closely with those they serve, so they can increase the quality of care and minimize the potential for unnecessary disruption in services." In a March 14, 2017, letter, Verma and Price advised state governors that they planned to extend the compliance period and discussed other planned changes to the Medicaid program (see Did CMS just sound the death knell for Medicaid expansion?, March 15, 2017).

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