New CMS Guidance Threatens HCBS Demonstrations, Could Limit PA Innovations
Key Questions
What is the new CMS guidance on Section 1115 waivers?
The guidance tightens budget neutrality requirements for Medicaid demonstration programs, potentially limiting states' HCBS innovations. It introduces stricter monitoring and actuary certification, with an effective date of January 2027.
How could this guidance affect Pennsylvania's HCBS programs?
It may restrict Pennsylvania's ability to expand home- and community-based services for seniors aging in place. Advocates worry this will reduce flexibility for new demonstrations under Section 1115 waivers.
What concerns have been raised by advocates regarding the guidance?
Advocates fear it will stifle innovation in home- and community-based services by imposing tighter financial oversight. The changes could curtail ongoing or planned HCBS demonstrations across states.
New CMS guidance tightening budget neutrality for Section 1115 waivers could curtail HCBS demonstrations. Advocates fear it will stifle innovation in home- and community-based services. Takes effect Jan 2027. A new article confirms the effective date and adds details on actuary certification and stricter monitoring. This could impact Pennsylvania's ability to expand HCBS options for seniors aging in place.