The New HCBS Rule Reshaping Community-Based Services

On January 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule defining standards for community settings eligible to provide Medicaid home- and community-based services (HCBS). Assisted living facilities are not explicitly excluded as HCBS settings under the rule, but are required to demonstrate that they meet all qualifications of the new community standards. Institutional settings explicitly excluded from serving as an HCBS setting include nursing facilities, institutions for mental diseases (IMDs), and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs). Additionally, the final rule excludes settings within or near an institution if . . .