I 

118TH CONGRESS 

2D SESSION H. R. 8106 

To amend title XIX of the Social Security Act to increase transparency 

and expand coverage options with respect to home and communitybased services under a Medicaid waiver. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 23, 2024 

Mrs. RODGERS of Washington (for herself and Mr. PALLONE) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to increase 

transparency and expand coverage options with respect 

to home and community-based services under a Medicaid 

waiver. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. INCREASING TRANSPARENCY AND EXPANDING 

4 HCBS COVERAGE OPTIONS. 

5 Section 1915(c) of the Social Security Act (42 U.S.C. 

6 1396n(c)) is amended— 

7 (1) in paragraph (2)— 

8 (A) in subparagraph (E)— 


ssavage on LAPJG3WLY3PROD with BILLS
2 

•HR 8106 IH

1 (i) by inserting ‘‘, not less frequently 

2 than’’ before ‘‘annually’’; and 

3 (ii) by inserting ‘‘(including, with re4 spect to such information provided on or 

5 after January 1, 2028, the information 

6 specified in paragraph (12))’’ before the 

7 period at the end; and 

8 (B) by adding at the end the following 

9 flush sentence: 

10 ‘‘The Secretary shall make all information provided under 

11 subparagraph (E) on or after January 1, 2028, publicly 

12 available on the website of the Centers for Medicare & 

13 Medicaid Services.’’; and 

14 (2) by adding at the end the following new 

15 paragraphs: 

16 ‘‘(11)(A) Notwithstanding paragraph (1), the 

17 Secretary may approve a waiver under this sub18 section for a State to include as medical assistance 

19 under the State plan of such State payment for part 

20 or all of the cost of home or community-based serv21 ices (other than room and board (as described in 

22 such paragraph)) approved by the Secretary which 

23 are provided pursuant to a written plan of care to 

24 individuals other than individuals described in such 


ssavage on LAPJG3WLY3PROD with BILLS
3 

•HR 8106 IH

1 paragraph if such State meets the requirements 

2 specified in subparagraph (B). 

3 ‘‘(B) For purposes of paragraph (1), the re4 quirements specified in this paragraph are, with re5 spect to a State, the following: 

6 ‘‘(i) As of the date that such State re7 quests a waiver under this subsection to provide 

8 home or community-based services to individ9 uals with respect to whom there has not been 

10 a determination described in such paragraph 

11 made, all other waivers (if any) granted under 

12 this subsection with respect to the State plan 

13 meet the requirements of this subsection. 

14 ‘‘(ii) The State demonstrates to the Sec15 retary that approval of a waiver under this sub16 section with respect to individuals described in 

17 clause (i) will have no material impact on the 

18 average amount of time that individuals with 

19 respect to whom a determination described in 

20 paragraph (1) has been made will need to wait 

21 to receive home or community-based services 

22 under any waiver granted under this subsection. 

23 ‘‘(iii) The State provides to the Sec24 retary— 


ssavage on LAPJG3WLY3PROD with BILLS
4 

•HR 8106 IH

1 ‘‘(I) an estimate of the number of in2 dividuals described in clause (i) that the 

3 State will make such services available to 

4 under a waiver under this subsection; and 

5 ‘‘(II) a description of how the types 

6 and quantities of such services furnished to 

7 such individuals under such a waiver may 

8 differ from the types and quantities of 

9 such services furnished to individuals not 

10 described in clause (i) under such a waiver. 

11 ‘‘(12) For purposes of paragraph (2)(E), the 

12 information specified in this paragraph is the fol13 lowing: 

14 ‘‘(A) In the case of a State that limits the 

15 number of individuals who may be provided 

16 home or community-based services under a 

17 waiver granted under this subsection— 

18 ‘‘(i) a description of how the State 

19 maintains its list of individuals who have 

20 applied to receive such services under such 

21 waiver but who, due to such limit, have not 

22 yet been approved to receive such services; 

23 ‘‘(ii) information on whether the State 

24 screens individuals on such list to deterVerDate Sep 11 2014 22:20 May 14, 2024 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8106.IH H8106

ssavage on LAPJG3WLY3PROD with BILLS
5 

•HR 8106 IH

1 mine whether such individuals are eligible 

2 to receive such services under such waiver; 

3 ‘‘(iii) information on whether (and, if 

4 applicable, how often) the State periodi5 cally re-screens such individuals to deter6 mine whether such individuals are so eligi7 ble; and 

8 ‘‘(iv) the average amount of time that 

9 individuals approved to receive such serv10 ices were on such list. 

11 ‘‘(B) A description of the types of services 

12 furnished under waivers under this subsection, 

13 including the following: 

14 ‘‘(i) The average amount of time from 

15 when such services are initially approved 

16 for an individual to when such individual 

17 begins receiving such services. 

18 ‘‘(ii) With respect to the most recent 

19 1-year period ending on the date that such 

20 information is provided to the Secretary 

21 for which data is available (or such other 

22 period as may be specified by the Sec23 retary), the average percentage of hours of 

24 home or community-based services author25 ized under written plans of care for indiVerDate Sep 11 2014 22:20 May 14, 2024 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8106.IH H8106

ssavage on LAPJG3WLY3PROD with BILLS
6 

•HR 8106 IH

1 viduals receiving such services under a 

2 waiver granted under this subsection that 

3 are actually furnished to such individual. 

4 ‘‘(C) Information regarding access to 

5 homemaker services, home health aide services, 

6 and personal care services under waivers under 

7 this subsection, including the following: 

8 ‘‘(i) With respect to the most recent 

9 1-year period ending on the date that such 

10 information is provided to the Secretary 

11 for which data is available, the average 

12 amount of time from when homemaker 

13 services, home health aide services, or per14 sonal care services are initially approved to 

15 be furnished to individuals under such a 

16 waiver to when services began. 

17 ‘‘(ii) With respect to the period de18 scribed in clause (i), the average percent19 age of hours of homemaker services, home 

20 health aide services, and personal care 

21 services authorized under written plans of 

22 care for individuals receiving such services 

23 under a waiver granted under this sub24 section that are actually furnished to such 

25 individual.’’. 


ssavage on LAPJG3WLY3PROD with BILLS
7 

•HR 8106 IH

1 SEC. 2. CMS GUIDANCE TO STATES ON INTERIM COVERAGE 

2 UNDER WAIVER. 

3 Not later than January 1, 2025, the Secretary of 

4 Health and Human Services shall issue guidance to the 

5 States to clarify how a State with a waiver in effect under 

6 section 1915(c) of the Social Security Act (42 U.S.C. 

7 1396n(c)) may provide, with respect to an individual who 

8 is eligible for home and community-based services (as such 

9 term is described in such section) under such waiver, up 

10 to 60 days of coverage of such services under an interim 

11 care plan for the period beginning on the date such eligi12 bility is determined and ending on the date that a written 

13 plan of care (as such term is described in such section) 

14 with respect to such individual is finalized. 

Æ 


ssavage on LAPJG3WLY3PROD with BILLS