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HCBS settings evidentiary packages

The Centers for Medicare & Medicaid Services (CMS) requires states to submit evidentiary packages for settings that CMS presumes are not home and community-based. Evidentiary packages include information gathered during on-site visits and the provider-attestation process. CMS will conduct heightened-scrutiny assessments for settings that meet the following criteria:

  • Prong 1 settings: Located in a hospital, nursing facility, intermediate care facility (ICF-DD) or institution for mental disease (IMD).
  • Prong 2 settings: Located adjacent to a public hospital, nursing facility, ICF-DD or IMD.
  • Prong 3 settings: Have the effect of isolating people from the broader community of people who do not receive HCBS.

This is the first round of evidentiary packages to be submitted to CMS after public comment. We will submit additional rounds of evidentiary packages for comment throughout 2019.

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