HCBS Providers: If Not Already Compliant, Make Sure You’re Working Toward HCBS Compliance

As of July 1, 2022, Wisconsin MCOs were required to report to DHS’s Division of Medicaid Services of any setting who they cannot reach or who has indicated that they do not wish to become HCBS compliant.

DMS has clarified with WHCA/WiCAL that providers should take action to come into HCBS compliance, but providers do not have to be fully compliant by the original June 15, 2022 date. As long as providers are working toward compliance as of July 1, resident relocation will not occur.

If they receive or want to receive Medicaid waiver funding, they can initiate the HCBS compliance request process. These are the instructions we share with interested providers who currently show as “no determination.”

A HCBS compliance determination is required for each licensed or certified residential facility receiving Medicaid waiver funding. The following process applies to 3-4 bed adult family homes (AFH), community-based residential facilities (CBRF), and certified residential care apartment complexes (RCAC). Please complete the following process for any licensed or certified facility that does not currently have a HCBS compliance determination.

  1. Review the Medicaid HCBS information
  2. Review the Wisconsin HCBS Waivers information.
  3. Implement the HCBS requirements as defined by Wisconsin at your facility.
  4. Complete and submit the HCBS Compliance Review Request, F-02138 with the required supporting documentation to your Bureau of Assisted Living Regional Office.

In order for a determination of HCBS compliance to be made, you must complete step 4 highlighted above for each licensed or certified facility. E-mail the HCBS Compliance Review Request, F-02138 to the correct Bureau of Assisted Living Regional Office based on the location of the facility.

The CMS federal compliance deadline to have all waiver funded residents residing in HCBS Compliant settings is 03/17/2023. WI DHS requires facilities to be compliant or working toward HCBS compliance at this time. DMS will continue to work with all providers who intend to become HCBS compliant to ensure a smooth transition before the final 03/17/2023 federal implementation date. At this time, DMS has not selected a new deadline for providers to be fully compliant, but will expect providers to be working toward compliance. Providers can contact their Bureau of Assisted Living Regional Office or DHSHCBSSettings@dhs.wisconsin.gov if they have questions regarding the HCBS compliance process.

PLEASE NOTE:  WHCA/WiCAL encourages members to achieve compliance now rather than wait and potentially experience additional compliance challenges as a new compliance deadline approaches in the future.

Check your HCBS compliance status using the Division of Quality Assurance (DQA) Provider Search.

  • The facility’s HCBS Compliance Status is listed in the Additional Provider Information Section.  A facility that has been determined to be HCBS compliant will have an HCBS Compliance Status of “Compliant”.
  • Provider Search is updated weekly
  • Compliance is required for each licensed or certified facility receiving Medicaid HCBS waiver funds. This should be confirmed by the setting’s DQA facility ID.
  • See How to use Provider Search for more information.
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