This session focused on comparing federal requirements across the various Section 1915 authorities that states use to operate home- and community-based services (HCBS) programs. The presentation provided a brief overview of Medicaid HCBS, focusing on waiver and state plan options, as well as state considerations in selecting Medicaid HCBS Section 1915 authorities. Staff also presented results from 17 interviews with policy experts, states, and federal officials on state experiences adhering to the following five categories of administrative requirements: (1) reporting, monitoring, and quality improvement; (2) application, approval, and renewal processes; (3) public input; (4) cost-neutrality; and (5) conflict of interest. Staff shared interviewees’ feedback on each requirement, as well as opportunities to streamline or otherwise address challenges associated with complying with the requirements.
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Medicaid and CHIP Payment and Access Commission