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Independent Living News & Policy from the National Council on Independent Living

HCBS Heightened Scrutiny Q & A Released

These 2014 federal home and community-based services (HCBS) regulations require that any setting receiving Medicaid HCBS funding has specific community qualities and is not institutional in nature. If a setting is presumed to have institutional qualities, they may be approved to continue providing Medicaid HCBS through “heightened scrutiny”.

Each state is required to conduct reviews of their HCBS settings, and as this happens, stakeholders are encouraged to comment. This Q & A (PDF) was developed to help advocates understand the requirements of the HCBS regulations and to effectively participate in the public comment process.

For more on the state HCBS transition process, please see

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