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HCBS settings heightened-scrutiny process

The Centers for Medicare & Medicaid Services requires states to submit evidentiary packages for settings that CMS presumes are not home and community-based to undergo a heightened-scrutiny process. Evidentiary packages include information gathered during on-site visits and the provider-attestation process. On March 22, 2019, CMS issued Frequently Asked Questions Regarding the Heightened Scrutiny Review Process and Other Home and Community-Based Settings Information (PDF) (see definitions below). CMS randomly selected prong 1 and 2 settings to undergo the heightened-scrutiny process using a list provided by the state. The guidance also addresses the process for settings presumed to be isolating (Prong 3).

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