CMS grants 27 states initial approval on HCBS statewide transition plans, full list here

To date, the Centers for Medicare & Medicaid Services (CMS) have granted initial approval to 27 states for their statewide transition plans (STP) required under the home and community-based services (HCBS) regulations. Initial approval is communication from CMS to the state notifying them that:

  • Public comment, input and summary requirements are met
  • The STP is sufficient
  • Systemic and/or site-specific assessments are not yet completed

CMS’ response to the state regarding initial approval will vary dependent on whether the state has or has not identified settings that are presumed to have institutional characteristics and any information the state may wish CMS to consider under the heightened scrutiny process.

In order to receive final approval, states’ STPs must:

  • Meet public comment, input and summary requirements
  • The STP must provide all necessary information including but not limited to:
    • systemic assessment
    • site specific assessment
    • settings presumed to have institutional characteristics
    • information regarding heightened scrutiny or the state’s decision to let the presumption stand
    • clear remedial steps with milestones are delineated

States that have received initial approval include:

Alabama — initial approval letter

Alaska — initial approval letter

Arkansas — initial approval letter

Connecticut — initial approval letter

Delaware — initial approval letter

Hawaii — initial approval letter

Idaho — initial approval letter

Indiana — initial approval letter

Iowa — initial approval letter

Kentucky — initial approval letter

Louisiana — initial approval letter

Missouri — initial approval letter

Montana— initial approval letter

Nebraska — initial approval letter

New Mexico — initial approval letter

North Dakota — initial approval letter

Ohio — initial approval letter

Oklahoma — initial approval letter

Oregon — initial approval letter

Pennsylvania — initial approval letter

Rhode Island — initial approval letter

South Carolina — initial approval letter

Tennessee — received initial and final approval

Utah — initial approval letter

Virginia — initial approval letter

Washington — initial approval letter

West Virginia — initial approval letter

All available documents related to states’ individual STPs can be found here, and are updated as states and CMS submit additional documents.

The final rule, which addresses several sections of Medicaid law under which states may use Medicaid funds to pay for home and community-based services, was published in January 2014 and can be accessed here.

For HCBS guidance, visit the HCBS webpage.

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