The Ensuring Access to Medicaid Services (Access Rule) final rule advances access to care and quality of care, and will improve health outcomes for Medicaid beneficiaries across fee-for-service (FFS) and managed care delivery systems, including home- and community-based services (HCBS) provided through those delivery systems. The Access rule addresses critical dimensions of access across both Medicaid FFS and managed care delivery systems, including for HCBS. These improvements seek to increase transparency and accountability, standardize data and monitoring, and create opportunities for states to promote active beneficiary engagement in their Medicaid programs with the goal of improving holistic access to care.
Reporting
Compliance Reporting Federally required by July 9, 2027
- Critical Incident Management System
Updated: TBD
The State must report, every 24 months on the results of an incident management system assessment to demonstrate that it meets the requirements outlined in § 441.302(a)(6). - Critical Incidents
Updated: TBD
The State must report to CMS annually on information regarding critical incidents as outlined in § 441.311(b)(2). - Person-Centered Planning
Updated: TBD
The State must report to CMS annually to demonstrate that the State meets the requirements at § 441.301(c)(3)(ii) regarding person-centered planning (as described in § 441.301(c)(1) through (3)).
Home and Community-Based Services Quality Measure Set Federally required by July 10, 2028
- HCBS Quality Measures Set
Updated: TBD
The State must report every two years on all measures in the Home and Community-Based Services Quality Measure Set that are identified by the Secretary pursuant to § 441.312(d)(1)(ii) of this subpart.
Access Reporting Federally required by July 9, 2027
- Access to Homemaker, Home Health Aide, Personal Care, and Habilitation Services
Updated: TBD
The State must report annually on the average amount of time from approval to delivery of services and percentage of authorized hours that are delivered.
Payment Rates
Rates Federally required by July 1, 2026
The State agency is required to publish all Medicaid fee-for-service fee schedule payment rates.
- DDS FFS Rates
Updated: 1/20/26 - Medi-Cal Rates (Department of Health Care Services)
Medi-Cal Rates are updated and effective as of the 15th of the month and published to the Medi-Cal website on the 16th of the month.
Specified Home and Community-Based Services Federally required by July 1, 2026
- HCBS (specified) Hourly Rates
Updated: 1/20/26
The State agency must publish a payment rate disclosure of the average hourly Medicaid FFS fee schedule payment rates for personal care, home health aide, homemaker, and habilitation services provided by individual providers and provider agencies.
References
Final Rule (Full Text)
Fact Sheet
Applicability Dates
- View Applicability Dates (Updated 9/9/24)
Note: The applicability dates reflected in the table are subject to change based on guidance released by the Centers for Medicare & Medicaid Services (CMS). For the latest CMS updates related to the Access Rule, please see the Federal Policy Guidance and Updates section below.
Federal Policy Guidance and Updates
- Exercise of Enforcement Discretion for Requirements for a Medicaid Fee-For-Service Grievance System for Home and Community-Based Services Until December 2027
Published 2/26/26 - Exercise of Enforcement Discretion until Calendar Year 2029 for Medicaid Interested Parties Advisory Group
Published 12/23/25 - Medicaid Program; Ensuring Access to Medicaid Services (CMS-2442-F)
Published 4/22/24
Last modified: July 16, 2026