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CMS Extends Deadlines for HCBS Settings Rule

The Centers for Medicare and Medicaid Services (CMS) extended heightened scrutiny and Settings Rule compliance deadlines by one year in a newly issued Home and Community-Based Services (HCBS) Settings Rule guidance document.

Due to the COVID-19 pandemic, CMS is extending the compliance deadline for the Settings Rule to March 17, 2023. Previously, the deadline was March 17, 2022. States now have until July 1, 2021 to submit to CMS a list of providers they had identified as having the effect of isolating individuals but who had since remediated and come into compliance with the rule. Providers identified by the state as being noncompliant with the Settings Rule due to isolating individuals who have not remediated and come into compliance will need to undergo federal heightened scrutiny. States previously were to submit a list of such providers to CMS by July 2020 for heightened scrutiny by October 2020. The timeline for this is now July 1, 2021 for the list of providers to be submitted to CMS and Oct. 31, 2021 for CMS to complete the heightened scrutiny review.

All providers identified by states as being located in the same building as a public or private institution, or on the grounds of or adjacent to a public institution, must undergo heightened scrutiny from CMS before being considered compliant with the Settings Rule. Previously, states were to submit a list of such providers to CMS by October 2020. The deadline for states to submit this list is now March 31, 2021.

The new guidance also includes language about providers who have changed their operations as a result of the pandemic:

If a setting has made significant and permanent changes to the services provided or the location in which those services are provided, the state may be required to reassess the setting, after the public health emergency, for compliance with the Settings Rule requirements.

Contact: Anne Hill, ahill@leadingageny.org, 518-867-8836 or Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828