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).
Update: CMS extends timelines for regulation of HCBS settings
On July 14, 2020, the federal Centers for Medicare & Medicaid Services (CMS) released guidance (in a letter [PDF]) announcing an extension to the implementation of the HCBS regulation timelines. In this letter, CMS extended the deadline for states to bring their systems into compliance with the HCBS settings requirements by a year (from March 17, 2022, to March 17, 2023).
For more information, visit the HCBS settings transition plan page.