Sunday, December 4, 2011

Revisiting Federal regulations on the use of Medicaid Waivers

Last April, the federal Centers for Medicare and Medicaid Services (CMS) proposed regulations that would restrict the use of Home and Community Based Service Waivers (this includes the Habilitation Supports Waiver for people with developmental disabilities in Michigan) to "prevent the provision of unnecessary or inappropriate care". The proposed regulations would effectively eliminate funding for Home and Community Based Services for many forms of congregate care for people with disabilities or for specialized services provided in group settings for people with specific disabilities. (See my blogposts from May and June 2011 for comments on specific issues raised by the proposed rules.)

There was a huge response to the proposed rules, both pro and con. Final rules have not yet been released by CMS.

According to an article in Disability Scoop, almost a hundred advocacy groups are demanding that CMS release the restrictive rules. CMS says there is no final date for publication of the rules, but they are a priority.

The proposed rules would limit the use of Medicaid Home and Community Based Services waivers to only those settings and services found acceptable by disability advocates who promote an ideology of full inclusion for everyone, regardless of the needs of the disabled person or the wishes of the individual and his or her family. The advocacy groups are aggressively pursuing a course that places them at odds with a significant segment of the population they presume to represent. This is a good time to remind CMS of how these restrictive regulations would affect your family member. 

Contacts at Centers for Medicare and Medicaid Services:

There is a new acting director of CMS, Marilyn Tavenner. Her e-mail address is .

Cindy Mann, Director, Center for Medicaid, CHIP, and Survey & Certification, can be contacted at

Henry Claypool is Director of the Health and Human Services Office on Disability. His e-mail is .

Refer to HCBS rules CMS-2296-P in the subject line of the e-mail.

Here is the letter sent by the National Disability Leadership Alliance.

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