July 8, 2026
2:00–3:30 pm ET
This training will provide an overview of federal requirements and CMS documentation expectations related to rate methodologies in Section 1915(c) Home and Community-Based Services (HCBS) waivers. The session will focus on how states document waiver service rate setting methodologies in Appendix I 2 a to demonstrate compliance with Medicaid payment regulations, including access to care, transparency, public notice, and ongoing oversight.
During this training, CMS will walk through common rate determination methods used across 1915(c) waiver programs, including fee schedules, tiered rates, negotiated market pricing, capitated payments, cost reconciliation methods, and outcome based payments. The session will highlight how CMS evaluates rate methodology documentation across these approaches and identify recurring documentation gaps and trends that result in requests for additional information during waiver review.
The training will also review key documentation considerations related to rate sufficiency, access monitoring, public input, and rate governance. CMS will share promising practices for clearly documenting rate methodologies when proposing new services, updating payment rates, or modifying existing rate structures, with the goal of supporting efficient CMS review and waiver approval.
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