Under recent guidance from the Centers for Medicare and Medicaid Services (CMS), state Medicaid programs have increased ability to relax financial eligibility standards for home and community-based services (HCBS). The gist of the guidance is summarized in two points: - In order to make it easier to qualify financially for HCBS, a state Medicaid program may choose to disregard specified amounts of an applicant’s income and/or resources.
- Any disregard can be limited to apply only to HCBS (and not also to nursing facility services), or only to certain HCBS programs or benefits.
A state’s authority to apply disregards is broad. As a practical matter, a principal benefit to states is the discretion to limit disregards to certain amounts, categories of beneficiaries, programs, or HCBS benefits. A disregard for only HCBS, for example, is less expensive to a state than extending the disregard to both HCBS and nursing facility services. The guidance gives several examples of allowable disregards. For example, a state could implement a disregard for persons who need HCBS waiver services but are currently on a waiver wait list. This disregard could allow these persons to receive non-waiver Medicaid services while waiting for an HCBS slot to open up. As another example, a disregard could allow a state to offer HCBS coverage to a married person without considering a spouse’s resources. Some states historically had followed this procedure—and had wanted to continue it—but until now have been required to consider both spouses’ resources under Medicaid’s spousal impoverishment protections. Justice in Aging will continue to monitor implementation of this new guidance and provide updates and support to our network. | |
