CMS Issues State Medicaid Director Letter and Expands Eligibility for HCBS

On December 7, CMS released a State Medicaid Director Letter providing guidance to states on how to expand eligibility for home and community-based services. The Sustaining Excellence in Medicaid Act of 2019 included a construction rule which allowed states the option to “target and tailor income and resource disregards” for individuals seeking home and community-based services under section 1915(c), (i), (k) and 1115 waivers.

The guidance provides greater flexibility to states in determining certain income and asset disregards, such as allowing for targeting income and resource disregards toward individuals within an eligibility group as well as toward individuals based on their particular HCBS needs. This would increase the number of people eligible to access home and community-based services.