New Medicaid rule requires patient-centered care for home- and community-based services, defines HCB

State Medicaid programs have been granted additional flexibility in providing home- and community-based services to elderly and disabled individuals, according to new regulations.

The Centers for Medicare & Medicaid Services has issued two final rules governing how states spend Medicaid funds on home and community based services (HCBS). The first rule, known as the Home and Community-Based State Plan Services Program and Provider Payment Reassignments, lifts existing “cumbersome” eligibility requirements on HCBS and institutional care under the Medicaid waiver program. “States will be better able to design and tailor Medicaid services to accommodate individual needs,” according to the rule.

Additionally, the Community First Choice Option rule establishes a new state option to provide HCBS, according to a Department of Health and Human Services regulatory agenda posting.

Both rules would give disabled and elderly individuals more alternatives to nursing home care. Recent administrations have expedited efforts to move as many residents as possible out of institutionalized long-term care, which they view as a costly option.

CMS sent these final rules to the Office of Management and Budget’s Office of Information and Regulatory Affairs, which has 60 days to review them prior to publishing them. Click here and here to view the rules.