The General Accounting Office is recommending the Centers for Medicare and Medicaid Services pay closer scrutiny to temporary changes to home-and-community-based services during public health emergencies and evaluate changes to HCBS during the COVID-19 pandemic.

During the pandemic, CMS allowed Medicaid-funded state programs to delay or suspend background checks, plan services over the phone instead of in-person, delay or suspend background checks and allow some services to be conducted in homes, rather than facilities. 

The GAO said CMS had no procedures to monitor those changes and relied on states to keep track of their impact. While CMS told GAO officials they intend to evaluate temporary changes to HCBS programs, it has not yet developed any plans to do so. The GAO said CMS’ reporting on changes to HCBS programs and how they might have prevented the spread of the coronavirus virus is not due for a few years. The GAO believes that could result in missed opportunities to prepare for future emergencies.

The Coronavirus Aid, Relief and Economic Security Act, an economic stimulus bill passed in March of 2020, includes a provision for the GAO to report on its ongoing COVID-19 monitoring and oversight efforts.