CMS Proposes Changes to the HCBS 1915(c) Waiver Application


In September 2023, the Centers for Medicare & Medicaid Services (CMS) posted proposed updates to the 1915(c) Home and Community Based Services (HCBS) Waiver Application and Technical Guide in the Federal Register for public comment. According to CMS, the changes include technical edits and updates throughout both documents, such as adding an option for states to indicate whether HCBS can be delivered via telehealth and integrating settings criteria with person centered service planning requirements.

Crosswalks of the major changes, as well as redlined and final versions of both documents are available here: 2023 1915(c) Waiver Application PRA Renewal Materials.

1915(c) waivers are flexible and extensive service packages and are the most predominant way that state Medicaid agencies provide HCBS across the country. Changes to the HCBS Waiver Application and Technical Guide can have significant impact on the way that states administer their benefits. The public comment period closes on November 13, 2023. The Federal Register posting, including instructions for providing public comment, is available here: Federal Register Notice for 1915(c) Waiver Application PRA Renewal.