On February 26, 2026, the Centers for Medicare and Medicaid Services (CMS) announced an 18‑month delay in enforcement of provisions in the Ensuring Access to Medicaid Services Rule requiring states to establish a fee‑for‑service (FFS) grievance system for home‑ and community‑based services (HCBS) recipients.

The Ensuring Access to Medicaid Services Rule was finalized by CMS on May 10, 2024, with an effective date of July 9, 2024. Many provisions within the regulation had differing compliance dates to provide states with adequate time to amend policies and systems to operationalize new requirements. States were to develop a process and related incident management system to track grievances levied by FFS HCBS recipients. This requirement was to be operationalized by July 9 of this year. CMS indicates, “This enforcement discretion will allow states to focus critical resources on implementing recent federal legislation.” This is not the first provision from the Access Rule to have delayed enforcement.

The bulletin, along with other guidance to states and prior notices of enforcement discretion are available here.