CMS Releases Community First Choice Final Regulations; Seeks More Input on When Housing Is “Community-Base”

As it continues implementation of the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) has released final regulations for the Community First Choice option (CFC).

CFC provides an incentive for state Medicaid programs to offer more extensive home and community-based services (HCBS): specifically, CFC increases the federal Medicaid match by six percent for HCBS that meet CFC standards.

CFC could be a game-changer for Medicaid beneficiaries in need of HCBS; because CFC is provided through a state-plan amendment rather than a waiver, CFC benefits must be made available throughout a state, not limited by (for example) enrollment caps or geographical restrictions.  CMS estimates that ultimately 30 percent of eligible persons who would want CFC coverage, will be residing in states that offer it.

An unresolved issue is how to define community-based settings.  CMS’s intent is to develop regulations on the community-character issue that will apply equally in all HCBS settings, with release of the final regulations anticipated in late 2012 or early 2013.  NSCLC currently is analyzing the proposed regulations, and will develop comments on the relevant issues to share in the near future with advocates and then with CMS. Read More

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