New CMS Guidance Threatens HCBS Demonstrations, Could Limit PA Innovations
Key Questions
What is the new CMS guidance on Medicaid waivers?
The guidance from the Trump administration tightens budget neutrality requirements and financial oversight for Section 1115 waivers. This change is expected to limit states' flexibility in running home- and community-based services (HCBS) demonstrations.
How might the guidance affect HCBS programs in Pennsylvania?
It could restrict Pennsylvania's ability to expand innovative HCBS options that help seniors age in place. Advocates are concerned this will reduce opportunities for new demonstrations and limit service innovations.
When does the new CMS guidance take effect?
The updated rules on budget neutrality for Section 1115 waivers begin in January 2027. States will need to comply with the stricter standards for their Medicaid demonstration programs starting then.
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. This could impact Pennsylvania's ability to expand HCBS options for seniors aging in place.