RCPA - Rehabilitation and Community Providers Association


CMS Issues New Waiver Rule
January 22, 2014

The Centers for Medicare and Medicaid Services (CMS) issued final rule on January 11, which defines “community” for Home and Community Based (HCBS) waiver services and settings. These new rules become effective March 17. States will have one year to bring HCBS settings into compliance with the new rules. The waivers covered by these rule changes include:

  • 1915(c), which states use to provide long-term care services in home and community settings rather than institutional settings. In Pennsylvania, these include the Consolidated and Person/Family Directed Support waivers through the Office of Developmental Programs and those funded through the Office of Long-Term Living, which include COMMCARE, Attendant Care, Independence, and OBRA waivers.
  • 1915(i) state plan options, which allows states to establish the Medicaid-eligible population being provided waiver services.
  • 1915(k) Community First Choice Option providing attendant services.

A CMS fact sheet reviews requirements that all HCBS settings must include:

  • Integrated in and supports full access to the community;
  • Ensures the individual’s rights of privacy, dignity, respect, and freedom from coercion and restraint;
  • Offers individuals choice regarding services and who provides them; and
  • Emphasizes person-centered service planning.

CMS is holding two webinars on these final rules:

  • January 23, 1:00 – 3:00 p.m., HCBS Final Rule, 877-267-1577; PIN 993724826.
  • January 30, 1:00 – 3:00 p.m.(repeat), HCBS Final Rule, 877-267-1577; PIN 990895287.

RCPA has contacted the Department of Public Welfare Office of Developmental Programs that is reviewing the rule and will provide clarification on system changes.

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