CMS RFI Seeks Input on Expanding HCBS

The Centers for Medicare and Medicaid Services (CMS) has issued a request for information (RFI) that seeks information and data on additional reforms and policy options that the agency can consider to accelerate the provision of home and community-based services (HCBS) to Medicaid beneficiaries “taking into account issues affecting beneficiary choice and control, program integrity, ratesetting, quality infrastructure, and the homecare workforce.”

The RFI specifically seeks input from the public on ways that CMS can use its statutory authority to accelerate this progress, as well as input into how best to ensure high quality HCBS that promote the health and well-being of beneficiaries, enhance policies that ensure the integrity of such services and protect beneficiaries from harm, and address workforce challenges particular to this set of services, such as wages, training and retention.

The RFI is organized into four separate topic areas:

  • What are the additional reforms that CMS can take to accelerate the progress of access to HCBS and achieve an appropriate balance of HCBS and institutional services in the Medicaid long-term services and supports (LTSS) system to meet the needs and preferences of beneficiaries?
  • What actions can CMS take, independently or in partnership with states and stakeholders, to ensure quality of HCBS including beneficiary health and safety?
  • What program integrity safeguards should states have in place to ensure beneficiary safety and reduce fraud, waste and abuse in HCBS?
  • What are specific steps CMS could take to strengthen the HCBS home care workforce, including establishing requirements, standards or procedures to ensure rates paid to home care providers are sufficient to attract enough providers to meet service needs of beneficiaries and that wages supported by those rates are sufficient to attract enough qualified home care workers.

Comments must be received no later than 5 p.m. on January 9, 2017.

FMI: The RFI is available at