For HCBS Providers

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Become an HCBS Provider

Visit the Iowa Medicaid webpage to learn more about waivers, Habilitation and other Iowa Medicaid programs. 

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Find an HCBS Specialist

Iowa Medicaid's Quality Improvement Organization (QIO) has a team of professionals dedicated to quality oversight and technical assistance for HCBS and Community-Based Neurobehavioral Rehabilitation Services (CNRS) providers. HCBS Specialists generally serve providers with main office locations based within the Specialist's assigned region. 

  • Some Specialists are dedicated to managing incidents and complaints related to HCBS and CNRS providers or members.
  • One Specialist is dedicated to reviewing applications, providing technical assistance and supporting applicants and new providers.

The provided links offer current region map and listing of HCBS Specialists.

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HCBS Settings

In 2014, The Centers for Medicare and Medicaid (CMS) made rules defining HCBS and outlining under what circumstances HCBS funding can be used. The goal of these rules was to make sure HCBS funding is truly used to support people to lead non-institutional lifestyles. The rules required HCBS to be provided in such a way that recipients:

  • are integrated into their communities;
  • are supported to make every day and major life choices;
  • access community life and resources;
  • experience autonomy; and
  • are afforded other important consumer protections and human rights. 

Reporting New Settings

Effective March 17, 2023, HCBS Waiver and Habilitation providers must report and receive approval for new residential and non-residential settings prior to using HCBS funding in the setting. March 17, 2023, marked the end of the transition period for states to fully comply with the Centers for Medicare & Medicaid Services (CMS) final rule for HCBS settings. The HCBS settings rule requires states to ensure all settings where HCBS waiver and Habilitation services are provided comply with HCBS settings requirements rule prior to receiving HCBS funding in the setting. 

For instructions for reporting new settings, see Informational Letter (IL) No. 2571.

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Disenrolling or Discontinuing Services

Providers wishing to discontinue or disenroll from specific services, settings or the entire organization may contact their HCBS Specialist for assistance.

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Quality Oversight

Iowa Medicaid has had a robust HCBS quality oversight system in place for over thirty years. This quality oversight system includes regular, ongoing review of providers of HCBS waiver and Habilitation services. 

Iowa Medicaid's QIO HCBS team is responsible for all quality oversight activities for the HCBS waiver and Habilitation providers, including the review and assessment of HCBS settings

Quality oversight includes, but is not limited to, annual provider self-assessment, Periodic or Certification Reviews, CNRS Periodic Reviews, Focused Reviews and review of incidents and complaints (also known as Targeted Reviews). 

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Help with HCBS & Waivers

  • For general HCBS questions, please email the HCBS Specialist team at hcbswaivers@hhs.iowa.gov
  • To report an issue or voice a complaint related to an HCBS or CNRS provider, or for general questions about HCBS incident reporting, please email the Incident and Complaint team at hcbsir@hhs.iowa.gov
  • For waiver slot questions, please email the slot manager at waiverslot@hhs.iowa.gov.
  • To refer an HCBS setting for assessment or to report an issue related to HCBS settings, please contact the HCBS team at hcbssettings@hhs.iowa.gov
  • For general CNRS questions, please email the HCBS/CNRS Specialist team at cnrs@hhs.iowa.gov
  • Please note that the hcbsqi@hhs.iowa.gov email box is not regularly monitored outside of the annual self-assessment season (October through December).
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