What Does The CMS Final Rule Defining HCBS Settings Imply For States, Providers & Participants?

On January 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule defining community standards for settings eligible for Medicaid reimbursement for home‐ and community-based services (HCBS). Eligibility requires that participants receiving HCBS services not be isolated from the community and explicitly excludes institutional settings. CMS defines eligible settings not by location but by how a participant experiences services in that setting. The approach is person-centered and individualized with an emphasis on choice of services and providers where possible. Settings must meet all qualifications established under the rule to be eligible for Medicaid reimbursement . . .