HCBS Rule Implementation

May 26, 2022



During a webinar held today in association with correspondence from ANCOR, it was announced that CMS, in partnership with the Administration for Community Living (ACL), is moving forward with a strategy that aligns the focus of federal support and state compliance activities with the realities of the direct-service workforce crisis exacerbated by the COVID-19 PHE.


CMS will authorize states to submit a request for a Corrective Action Plan by December 1, 2022, to continue federal reimbursement of HCBS beyond the end of the transition period, if states need additional time to ensure full provider compliance with certain regulatory criteria related directly to the workforce crisis or other impacts relevant to the PHE.  If a request is made, states must show how the PHE directly impacted their ability to meet the criteria, what the state has done in an effort to meet this criteria and what barriers that will need to be overcome and a timeline for them to meet the criteria.

Examples of areas that may potentially qualify for a CAP are:

  • Access to the broader community;
  • Opportunities for employment;
  • Option for a private unit and/or choice of a roommate; and
  • Choice of non-disability specific settings.

However, each state and provider setting must show that the basic criteria of the HCB Settings are in compliance by March 17, 2023. 

It was noted that only half of the states have final approval of their state transition plan.  Virginia has already received final approval of the state transition plan as found at the link below:


It is unclear whether Virginia will respond in seeking a corrective action plan but they should be talking with stakeholders about this as an option to full compliance by March 2023.

The webinar was recorded and should be made available on www.medicaid.gov however, the slide deck is available at this link https://www.medicaid.gov/medicaid/home-community-based-services/downloads/hcbs-settings-rule-imp.pdf