On April 22, 2024 the Centers for Medicare & Medicaid Services (CMS) published the Medicaid Program; Ensuring Access to Medicaid Services final rule. The rule has a particular focus on home- and community-based services (HCBS), including direct care worker compensation requirements, HCBS waitlists, grievance process development, critical incident reporting definitions and HCBS quality reporting. The final rule also seeks to increase transparency in payment rates.

The rule is effective 60 days after publication, but many provisions have an effective date that widely differs from the overarching effective date. CMS released a fact sheet on the regulation and a timeline for the various effective dates.