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This Q&A provides an overview of the requirements of 2014 federal rules that any setting receiving Medicaid home and community based services (HCBS) funding must have certain community qualities and not be institutional in nature. It also covers when a setting presumed to have institutional qualities may be approved to continue providing Medicaid HCBS through a process called “heightened scrutiny.”

HCBS Regulations Q&A Heightened Scrutiny