This session previewed a draft chapter on timely access to home- and community-based services (HCBS) that will be included in the March 2025 report to Congress. States have a number of ways in which they can expedite Medicaid eligibility determinations and enrollment for individuals whose income is not determined using modified adjusted gross income (MAGI) and who need HCBS. In particular, the chapter focuses on the use of presumptive eligibility and expedited eligibility flexibilities for non-MAGI populations, as well as provisional plans of care. It provides background on these topics, as well as the findings from our stakeholder interviews, environmental scan, and review of Section 1915(c) HCBS waivers. It concludes with a recommendation to the Secretary of the U.S. Department of Health and Human Services to direct the Centers for Medicare & Medicaid Services to issue guidance on how states can use provisional plans of care, including policy and operational considerations, under Section 1915(c), Section 1915(i), Section 1915(k), and Section 1115 of the Social Security Act.
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Medicaid and CHIP Payment and Access Commission
