Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
Updated 7:40 AM MT
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Federal Policy·February 26, 2026

CMS Delays HCBS Fee-For-Service Grievance System Enforcement Until December 2027

CMS will not enforce the federal requirement for states to establish fee-for-service grievance systems for home and community-based services until December 31, 2027. The enforcement discretion applies to 42 CFR 431.205(d), which requires states to implement grievance procedures for HCBS beneficiaries in FFS arrangements comparable to managed care protections. States must still comply with all other due process and fair hearing requirements under existing federal rules. The delay gives states additional time to develop compliant systems while CMS considers whether regulatory modifications are needed.

Why it matters

States operating HCBS programs under fee-for-service models gain nearly two additional years to build grievance infrastructure without federal enforcement action, affecting implementation timelines and compliance priorities for state Medicaid agencies.

LTSS · Long-Term Care

Read the full article at medicaid.gov

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