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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 guidance describing the new heightened-scrutiny process for prong 1 and 2 settings (PDF) (see definitions below). CMS will randomly select 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). DHS will send an announcement related to settings presumed to be isolating at a later date.

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