,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #hajf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #bc1 #bjbd,mrs4
 ,rodg]s ( ,wa%+ton 7= h]self & ,mr4    
,pallone7 introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,en]gy &     
,comm]ce  ,a ,,bill  ,to am5d title     
,,xix ( ! ,social ,security ,act to     
increase transp>5cy & exp& cov]age      
options ) respect to home &             
community-bas$ s]vices "u a ,m$icaid    
waiv]4  #a4 ,increas+ transp>5cy & exp&+
 ,,hcbs cov]age options ,section        
#aiae7;c7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acifn7c77 is am5d$--    
7#a7 9 p>agraph 7#b7-- 7,a7 9           
subp>agraph 7,e7-- 7i7 by ins]t+ 1 n    
less frequ5tly ?an be=e annually2 &     
7ii7 by ins]t+ 7includ+1 ) respect to   
su* in=mation provid$ on or aft] ,janu>y
 #a1 #bjbh1 ! in=mation specifi$ 9      
p>agraph 7#ab77 be=e ! p]iod at ! end2 &
  7,b7 by add+ at ! end ! foll[+ flu%   
s5t5ce3 ,! ,secret>y %all make all      
in=mation provid$ "u subp>agraph 7,e7 on

 or aft] ,janu>y #a1 #bjbh1 publicly    
available on ! website ( ! ,c5t]s =     
,m$ic>e  ,m$icaid ,s]vices4 2 &  7#b7 by
 add+ at ! end ! foll[+ new p>agraphs3  
7#aa7 7,a7 ,not)/&+ p>agraph 7#a71 !    
,secret>y may approve a waiv] "u ?is    
subsection = a ,/ate to include z m$ical
 assi/ance "u ! ,/ate plan ( su* ,/ate  
paym5t = "p or all ( ! co/ ( home or    
community-bas$ s]vices 7o!r ?an room &  
bo>d 7z describ$ 9 su* p>agraph77       
approv$ by ! ,secret>y :i* are provid$  
pursuant to a writt5 plan ( c>e to      
individuals o!r ?an individuals describ$
 9 su* p>agraph if su* ,/ate meets !    
requirem5ts specifi$ 9 subp>agraph 7,b74
  7,b7 ,= purposes ( p>agraph 7#a71 !   
requirem5ts specifi$ 9 ?is p>agraph are1
 ) respect to a ,/ate1 ! foll[+3 7i7 ,z 
( ! date t su* ,/ate reque/s a waiv] "u 
?is subsection to provide home or       
community-bas$ s]vices to individuals ) 
respect to :om !re has n be5 a          
det]m9ation describ$ 9 su* p>agraph     
made1 all o!r waiv]s 7if any7 grant$ "u 

?is subsection ) respect to ! ,/ate plan
 meet ! requirem5ts ( ?is subsection4   
7ii7 ,! ,/ate demon/rates to ! ,secret>y
 t approval ( a waiv] "u ?is subsection 
) respect to individuals describ$ 9     
clause 7i7 w h no mat]ial impact on !   
av]age am\nt ( "t t individuals )       
respect to :om a det]m9ation describ$ 9 
p>agraph 7#a7 has be5 made w ne$ to wait
 to receive home or community-bas$      
s]vices "u any waiv] grant$ "u ?is      
subsection4  7iii7 ,! ,/ate provides to 
! ,secret>y-- 7,i7 an e/imate ( ! numb] 
( individuals describ$ 9 clause 7i7 t ! 
,/ate w make su* s]vices available to "u
 a waiv] "u ?is subsection2 &  7,,ii7 a 
description ( h[ ! types & quantities ( 
su* s]vices furni%$ to su* individuals  
"u su* a waiv] may diff] f ! types &    
quantities ( su* s]vices furni%$ to     
individuals n describ$ 9 clause 7i7 "u  
su* a waiv]4  7#ab7 ,= purposes (       
p>agraph 7#b77;,e71 ! in=mation specifi$
 9 ?is p>agraph is ! foll[+3 7,a7 ,9 !  
case ( a ,/ate t limits ! numb] (       

individuals :o may be provid$ home or   
community-bas$ s]vices "u a waiv] grant$
 "u ?is subsection-- 7i7 a description (
 h[ ! ,/ate ma9ta9s its li/ (           
individuals :o h appli$ to receive su*  
s]vices "u su* waiv] b :o1 due to su*   
limit1 h n yet be5 approv$ to receive   
su* s]vices2  7ii7 in=mation on :e!r !  
,/ate scre5s individuals on su* li/ to  
det]m9e :e!r su* individuals are        
eligible to receive su* s]vices "u su*  
waiv]2  7iii7 in=mation on :e!r 7&1 if  
applicable1 h[ (t57 ! ,/ate p]iodically 
re-scre5s su* individuals to det]m9e    
:e!r su* individuals are s eligible2 &  
7iv7 ! av]age am\nt ( "t t individuals  
approv$ to receive su* s]vices 7 on su* 
li/4  7,b7 ,a description ( ! types (   
s]vices furni%$ "u waiv]s "u ?is        
subsection1 includ+ ! foll[+3 7i7 ,!    
av]age am\nt ( "t f :5 su* s]vices are  
initially approv$ = an individual to :5 
su* individual beg9s receiv+ su*        
s]vices4  7ii7 ,) respect to ! mo/ rec5t
 #a-ye> p]iod end+ on ! date t su*      

in=mation is provid$ to ! ,secret>y =   
:i* data is available 7or su* o!r p]iod 
z may be specifi$ by ! ,secret>y71 !    
av]age p]c5tage ( h\rs ( home or        
community-bas$ s]vices au?oriz$ "u      
writt5 plans ( c>e = individuals receiv+
 su* s]vices "u a waiv] grant$ "u ?is   
subsection t are actually furni%$ to su*
 individual4  7,c7 ,in=mation reg>d+    
access to homemak] s]vices1 home heal?  
aide s]vices1 & p]sonal c>e s]vices "u  
waiv]s "u ?is subsection1 includ+ !     
foll[+3 7i7 ,) respect to ! mo/ rec5t   
#a-ye> p]iod end+ on ! date t su*       
in=mation is provid$ to ! ,secret>y =   
:i* data is available1 ! av]age am\nt ( 
"t f :5 homemak] s]vices1 home heal?    
aide s]vices1 or p]sonal c>e s]vices are
 initially approv$ to be furni%$ to     
individuals "u su* a waiv] to :5 s]vices
 began4  7ii7 ,) respect to ! p]iod     
describ$ 9 clause 7i71 ! av]age p]c5tage
 ( h\rs ( homemak] s]vices1 home heal?  
aide s]vices1 & p]sonal c>e s]vices     
au?oriz$ "u writt5 plans ( c>e =        

individuals receiv+ su* s]vices "u a    
waiv] grant$ "u ?is subsection t are    
actually furni%$ to su* individual4  4  
#b4 ,,cms guidance to ,/ates on int]im  
cov]age "u waiv] ,n lat] ?an ,janu>y #a1
 #bjbe1 ! ,secret>y ( ,heal? & ,human   
,s]vices %all issue guidance to ! ,/ates
 to cl>ify h[ a ,/ate ) a waiv] 9 effect
 "u section #aiae7;c7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4 #acifn7c77
 may provide1 ) respect to an individual
 :o is eligible = home & community-bas$ 
s]vices 7z su* t]m is describ$ 9 su*    
section7 "u su* waiv]1 up to #fj days ( 
cov]age ( su* s]vices "u an int]im c>e  
plan = ! p]iod beg9n+ on ! date su*     
eligibility is det]m9$ & end+ on ! date 
t a writt5 plan ( c>e 7z su* t]m is     
describ$ 9 su* section7 ) respect to su*
 individual is f9aliz$4