A Tiny Bright Spot!

July 14, 2020

We received a State Medicaid Director Letter today from CMS that confirms that the final compliance deadline for for the HCBS Setting Rule has been pushed back from March 17, 2022 to March 17, 2023.  Their rationale is refreshingly applicable:

  • “States’ stay-at-home and/or safer-at-home orders and the process of social distancing have made it difficult, if not impossible, for states to accurately evaluate how an individual is experiencing community integration in current HCBS settings.

  • These necessary directives have seriously impacted not only the measurement of community integration for individuals, but the intent of the Settings Rule to ensure that individuals with disabilities and older adults have the opportunity to be active participants in their communities.

  • Lastly, older adults and individuals with disabilities who receive Medicaid HCBS often have underlying conditions that increase risks to health and welfare associated with COVID-19 that can further delay a return to integrated activities as they existed prior to the global pandemic.”


While site inspections and other activity specific to this purpose were not expected to be as time consuming or as intrusive as those related to DOJ, we knew that the requirements had to be met.  The one year delay will give DMAS some “wiggle room” to allow a more measured approach.  We expect some guidance forthcoming in the next several weeks.