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Implementation Guide: Individuals Receiving HCBS Under Institutional Rules

Guidance for the reviewable unit (RU) that describes the optional Medicaid eligibility group for individuals who would be eligible for Medicaid if they were living in an institution and who, were it not for the receipt of home and community-based services (HCBS), would require the level of care furnished in an institution. It provides the criteria under which individuals may be covered under this group, as well as the income and resource standards used.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 01, 2020

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.