In accordance to the March 14 letter, the CMS (Centers for Medicare & Medicaid Services) will work to give states with extra time to comply with a final rule in relation to the provision of home-and community-based services (HCBS) to Medicaid beneficiaries, new Health and Human Services Secretary Tom Price, M.D., and CMS Administrator Seema Verma, MPH, told governors
They said, “The extension is being sought by agency “in recognition of the importance of the reform efforts underway. Furthermore, we’ll be examining ways in which we can make better our engagement with states on the implementation of the HCBS rule, involving greater state involvement in the procedure of assessing compliance of particular settings.” Price and Verma didn’t explain.
Issued in January 2014, the final rule developed new reimbursement criteria for home- and community-based settings with the aim of enabling Medicaid beneficiaries to get services in settings that are integrated into the community instead of in skilled nursing facilities. Several assisted living communities have given home- and community-based services to their residents through Medicaid waivers. Under the rule, although, few settings — involving settings situated in buildings in which inpatient institutional treatment is provided, settings in buildings on the grounds of or adjacent to a public institution, or settings that isolate people from the broader community — are presumed ineligible for the waiver program unless they meet a heightened standard of proof.
States and all HCBS settings are required by rule to comply by the day of March 17, 2019.
States sustain to work on their transition policies and determine whether certain senior living settings qualify to give home- and community-based services. Tennessee sustains to be the mere state that has got final approval of its transition plan. 24 additional states have got initial approval of their policies, meaning that they have met public comment, input and summary requirements but systemic or site-specific assessments haven’t still been completed.
The letter of Price and Verma to the governors dealt other topics regarded to the Medicaid as well, involving the program’s expansion under the ACA (Affordable Care Act), potential alignment of private and public insurance, the continuation of Section 1115 demonstration projects and responses to the opioid epidemic of country.
They said, “Today we commit to ushering in a latest era for the federal and state Medicaid partnership where states have more freedom to design programs that meet the spectrum of diverse requirements of their Medicaid population.”