Page 247

139 STAT. 317 PUBLIC LAW 119–21—JULY 4, 2025 (2) NONAPPLICABILITY OF ALTERNATIVE COST SHARING.—Sec- tion 1916A(a)(1) of the Social Security Act (42 U.S.C. 1396o– 1(a)(1)) is amended, in the second sentence, by striking ‘‘or (j)’’ and inserting ‘‘(j), or (k)’’. (c) IMPLEMENTATION FUNDING.—For the purposes of carrying out the provisions of, and the amendments made by, this section, there are appropriated, out of any monies in the Treasury not otherwise appropriated, to the Administrator of the Centers for Medicare & Medicaid Services, $15,000,000 for fiscal year 2026, to remain available until expended. Subchapter E—Expanding Access to Care SEC. 71121. MAKING CERTAIN ADJUSTMENTS TO COVERAGE OF HOME OR COMMUNITY-BASED SERVICES UNDER MEDICAID. (a) EXPANDING HCBS COVERAGE UNDER SECTION 1915(C) WAIVERS.—Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) is amended— (1) in paragraph (3), by inserting ‘‘paragraph (11) or’’ before ‘‘subsection (h)(2)’’; and (2) by adding at the end the following new paragraph: ‘‘(11) EXPANDING COVERAGE FOR HOME OR COMMUNITY-BASED SERVICES.— ‘‘(A) IN GENERAL.—Beginning July 1, 2028, notwithstanding paragraph (1), the Secretary may approve a waiver that is standalone from any other waiver approved under this sub- section to include as medical assistance under the State plan of such State payment for part or all of the cost of home or community-based services (other than room and board (as described in paragraph (1))) approved by the Secretary which are provided pursuant to a written plan of care to individuals described in subparagraph (B)(iii). A waiver approved under this paragraph shall be for an initial term of 3 years and, upon the request of the State, shall be extended for additional 5-year periods unless the Secretary determines that for the previous waiver period the requirements specified under this subsection (excluding those excepted under subparagraph (B)) have not been met. ‘‘(B) STATE REQUIREMENTS.—In addition to the require- ments specified under this subsection (except for the require- ments described in subparagraphs (C) and (D) of paragraph (2) and any other requirement specified under this subsection that the Secretary determines to be inapplicable in the context of a waiver that does not require individuals to have a deter- mination described in paragraph (1)), a State shall meet the following requirements as a condition of waiver approval: ‘‘(i) As of the date that such State requests a waiver under this subsection to provide home or community-based services to individuals described in clause (iii), all other waivers (if any) granted under this subsection to such State meet the requirements of this subsection. ‘‘(ii) The State demonstrates to the Secretary that approval of a waiver under this subsection with respect to individuals described in clause (iii) will not result in a material increase of the average amount of time that individuals with respect to whom a determination described in paragraph (1) has been made will need to wait to receive Effective date. Determinations. Time periods.