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 community- 
based 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. INCREASING TRANSPARENCY AND EXPANDING 
HCBS COVERAGE OPTIONS. 
Section 1915(c) of the Social Security Act (42 U.S.C. 
1396n(c)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (E)— 
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(i) by inserting ‘‘, not less frequently 
than’’ before ‘‘annually’’; and 
(ii) by inserting ‘‘(including, with re-
spect to such information provided on or 
after January 1, 2028, the information 
specified in paragraph (12))’’ before the 
period at the end; and 
(B) by adding at the end the following 
flush sentence: 
‘‘The Secretary shall make all information provided under 
subparagraph (E) on or after January 1, 2028, publicly 
available on the website of the Centers for Medicare & 
Medicaid Services.’’; and 
(2) by adding at the end the following new 
paragraphs: 
‘‘(11)(A) Notwithstanding paragraph (1), the 
Secretary may approve a waiver under this sub-
section for a State to include as medical assistance 
under the State plan of such State payment for part 
or all of the cost of home or community-based serv-
ices (other than room and board (as described in 
such paragraph)) approved by the Secretary which 
are provided pursuant to a written plan of care to 
individuals other than individuals described in such 
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paragraph if such State meets the requirements 
specified in subparagraph (B). 
‘‘(B) For purposes of paragraph (1), the re-
quirements specified in this paragraph are, with re-
spect to a State, the following: 
‘‘(i) As of the date that such State re-
quests a waiver under this subsection to provide 
home or community-based services to individ-
uals with respect to whom there has not been 
a determination described in such paragraph 
made, all other waivers (if any) granted under 
this subsection with respect to the State plan 
meet the requirements of this subsection. 
‘‘(ii) The State demonstrates to the Sec-
retary that approval of a waiver under this sub-
section with respect to individuals described in 
clause (i) will have no material impact on the 
average amount of time that individuals with 
respect to whom a determination described in 
paragraph (1) has been made will need to wait 
to receive home or community-based services 
under any waiver granted under this subsection. 
‘‘(iii) The State provides to the Sec-
retary— 
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SEC. 2. CMS GUIDANCE TO STATES ON INTERIM COVERAGE 
UNDER WAIVER. 
Not later than January 1, 2025, the Secretary of 
Health and Human Services shall issue guidance to the 
States to clarify how a State with a waiver in effect under 
section 1915(c) of the Social Security Act (42 U.S.C. 
1396n(c)) may provide, with respect to an individual who 
is eligible for home and community-based services (as such 
term is described in such section) under such waiver, up 
to 60 days of coverage of such services under an interim 
care plan for the period beginning on the date such eligi-
bility is determined and ending on the date that a written 
plan of care (as such term is described in such section) 
with respect to such individual is finalized. 
Æ 
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