CMI briefingCMSResidential Care & HCBS Waivers

CMS Medicaid access rule: HCBS enforcement delays

FFS grievance enforcement moved to Dec. 31, 2027; Interested Parties Advisory Group to Jan. 1, 2029.

CMS Informational Bulletins (Dec. 23, 2025; Feb. 26, 2026); 42 CFR 441.301(c)(7) · Updated Nov 5, 2026

This page is CMI's own briefing on the topic, written by CMI. It is not the text of the regulation. Read the regulation itself in the Regulatory hub or at the official source.

ProvisionStatus
Grievance system (HCBS FFS)No enforcement action until Dec. 31, 2027 (previously July 9, 2026), per the Feb. 26, 2026 bulletin
Interested Parties Advisory GroupEnforcement delayed to Jan. 1, 2029 under the Dec. 23, 2025 bulletin
80% payment adequacyReported as unchanged by a Sept. 2026 industry analysis, with a 2030 date and state reporting due by 2028

The 80% payment adequacy item comes from a secondary source; confirm with CMS before relying on it.

View the official source ↗

General information, not legal advice. Requirements change; confirm against the official source before you act, or ask us how this applies to your organization.