The Medicaid program is seeking to make a new rule on what qualifies as a “community setting” for some reimbursable services. The proposed regulation was published in the Federal Register on May 3, 2012, along with related proposals to implement several reforms in the Affordable Care Act. The changes expand states’ authority for Medicaid to cover home and community-based services and supports (HCBS).
This new rule would clarify whether and what types of permanent supportive housing would be considered a community setting for eligible persons to receive HCBS. Generally, the new proposed definition of home and community-based setting emphasizes values of community integration and choice.
It also sets out conditions for when services are provided in a “provider-owned or controlled residential setting,” which, among other conditions, essentially describes permanent supportive housing. While the proposed rule clarifies opportunities for expanded access to Medicaid, states must act to implement federal authorities, and some limitations on eligibility remain.
These new guidelines are open for comment until Monday, July 2, 2012.
Click here for more information in the Federal Register.