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December 3, 2025
Recommendations for Mitigating Harms to People with Disabilities, Older Adults, and Caregivers from Medicaid Work Requirements
David Machledt and Jennifer Lav Issue Brief
*** Co-Authored with Natalie Kean, Jennifer Mathis, and Gelila Selassie The One Big Beautiful Bill Act (OBBBA) establishes unprecedented work requirements in Medicaid expansion. Prior experience has shown that people with disabilities, older adults, and caregivers who should be exempted from work requirements often lose coverage or are denied…
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December 1, 2025
Improving Your HCBS Waiver Through Public Comment
Elizabeth Edwards Issue Brief
This explainer, targeted toward people who use Medicaid Home and Community-Based Services (HCBS), encourages people to get involved in shaping on their state Medicaid HCBS programs through commenting on Medicaid waiver changes. It explains what makes an effective comment and where to find information about each HCBS program within…
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December 1, 2025
Strengthening the Home and Community-Based Services (HCBS) Grievance Process
David Machledt Issue Brief
In May 2024, the Centers for Medicare & Medicaid Services (CMS) finalized regulations meant to improve access to key Medicaid services for people with disabilities. Parts of the new regulations requires states to revamp how they receive and resolve issues that people using Home and Community Based Services experience…
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September 24, 2025
Interested Parties Advisory Groups: Meaningful Stakeholder Engagement to Ensure Adequate HCBS Payment Rates and Help Strengthen the Direct Care Workforce
Jennifer Lav, Brit Vanneman, and Syd Pickern Issue Brief
NHeLP in partnership with The Community Living Policy Center (CLPC) developed the following policy brief titled, “Interested Parties Advisory Groups: Meaningful Stakeholder Engagement to Ensure Adequate HCBS Payment Rates and Help Strengthen the Direct Care Workforce." The Interested Parties Advisory Group (IPAG) requirement, established under the Medicaid Access Rule,…
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November 25, 2024
Improving HCBS Waivers through Public Comment
Elizabeth Edwards and David Machledt Webinar
This webinar trains advocates how to navigate, analyze, and comment on 1915(c) waivers, the most common form of Medicaid HCBS programs. States must regularly renew and amend 1915(c) waivers, and give stakeholders the opportunity to provide input and suggest changes. Our expert presenters shared our recently published commenters' guide…
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September 12, 2024
Overview of Key Home and Community-Based Services (HCBS) Provisions in the Medicaid Access Rule
Jennifer Lav and David Machledt Fact Sheet
The Medicaid Act requires that state payments for Medicaid are sufficient to provide at least equivalent access to care for Medicaid beneficiaries as the general population in any given geographic area. Over the years, CMS has tried to enforce payment adequacy via increased monitoring and other requirements, but these…
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Recommendations for Mitigating Harms to People with Disabilities, Older Adults, and Caregivers from Medicaid Work Requirements

Improving Your HCBS Waiver Through Public Comment

Strengthening the Home and Community-Based Services (HCBS) Grievance Process

Interested Parties Advisory Groups: Meaningful Stakeholder Engagement to Ensure Adequate HCBS Payment Rates and Help Strengthen the Direct Care Workforce

Improving HCBS Waivers through Public Comment

Overview of Key Home and Community-Based Services (HCBS) Provisions in the Medicaid Access Rule