CMS Proposes New Rules for Home and Community-Based Services Access and Managed Care

The Centers for Medicare & Medicaid Services (CMS) has released two proposed access-related rules governing home and community-based services and managed care. The rules, Ensuring Access to Medicaid Services (CMS 2442-P) and Medicaid and CHIP Managed Care Access, Finance, and Quality (CMS-2439-P), were made available to the public late Thursday afternoon.

The rules cover a range of topics, including the introduction of a mandated wage percentage, reimbursement rates, and incident management system requirements. The CMS fact sheet on Ensuring Access to Medicaid Services provided some of the key features of the proposed rule:

• A new strategy for oversight, monitoring, quality assurance, and quality improvement for HCBS programs
• Strengthening person-centered service planning and incident management systems in HCBS
• Requiring states to establish grievance systems in FFS HCBS programs
• At least 80% of Medicaid payments for personal care, homemaker, and home health aide services be spent on compensation for the direct care workforce
• Requiring states to publish the average hourly rate paid to direct care workers delivering personal care, home health aide, and homemaker services
• Establishing an advisory group for interested parties to advise and consult on provider payment rates and direct compensation for direct care workers
• Requiring states to report on waiting lists in section 1915(c) waiver programs, service delivery timeliness for personal care, homemaker and home health aide services, and a standardized set of HCBS quality measures
• Promoting public transparency related to the administration of Medicaid-covered HCBS through public reporting of quality, performance, and compliance measures

ANCOR members should mark their calendars for the Members-Only Briefing webinar on the access-related rules scheduled for Wednesday, May 3, from 12:30-2 pm EDT. ANCOR will provide a detailed briefing of the content of both rules and provide opportunities for Q&A. Advance registration is required for the webinar.

ANCOR will also host its first in a series of Members-Only Feedback Forums on Tuesday, May 9, from 10:30 am-12 pm EDT for members to engage in discussion and feedback that informs ANCOR’s comments and advocacy. Register now to participate in the first feedback forum.

Regulating the equal access provision is a critically important moment for providers and will impact the future of community-based services. ANCOR is dedicated to keeping providers informed, engaged, and provided with the tools needed to offer comments and insight into the rules. The comment period for both rules will be open for 60 days from the publish date, beginning on May 3, 2023. If you’re interested in receiving the most up-to-date news on the Access Rule, become an ANCOR member today.