CMS Issues Heightened Scrutiny Information Bulletin

ANCOR is sharing this announcement by the Centers for Medicare and Medicaid Services (CMS) because the “heightened scrutiny” provision the Home and Community Based Settings (HCBS) Rule impacts the vast majority of services that our members provide.

As shared by CMS:

“The Centers for Medicare & Medicaid Services (CMS) issued an Informational Bulletin that describes how heightened scrutiny applies to construction of new settings that are presumed institutional as outlined in the home and community-based services (HCBS) settings rule at 42 CFR 441.301(c)(5). The Bulletin revises prior guidance issued in 2016 to now allow states to submit a setting to CMS for heightened scrutiny review prior to Medicaid beneficiaries receiving services in the setting.

CMS also clarifies in the Bulletin when Federal Financial Participation for Medicaid-funded HCBS will be available upon CMS determination that a newly constructed presumptively institutional setting adheres to the home and community-based settings requirements.

• CIB: Heightened Scrutiny Review of Newly Constructed Presumptively Institutional Settings”