Federal officials will not enforce a new grievance system requirement for people who use fee-for-service Medicaid home and community-based services until Dec. 31, 2027. States had been required to have the system in place by July 9, 2026, under the 2024 Access Rule.
CMS announced the delay in a CMCS Informational Bulletin dated Feb. 26, 2026, signed by Dan Brillman, director of the Center for Medicaid and CHIP Services. Disability Scoop reported on it April 17, 2026.
What the rule requires
The requirement, at 42 CFR 441.301(c)(7) and related sections, says states must set up a procedure for beneficiaries to file grievances about person-centered service planning and the HCBS settings rules. It applies only to fee-for-service HCBS under sections 1915(c), (i), (j) and (k) and section 1115 demonstrations. Managed care plans already have their own grievance systems.
Why CMS delayed it
According to the bulletin, some states said they need an electronic grievance system to meet the rule's timelines and recordkeeping requirements, and some want a single system that also handles critical incident management. Some said they could not meet the July 2026 date because of the time needed to change or build electronic systems. CMS said electronic systems are not required but the delay lets states build them and focus on implementing recent federal legislation.
CMS also said it will use the time to consider proposing changes to the requirements through future rulemaking. States may build the system sooner. In the meantime, CMS will monitor service planning and settings compliance through existing waiver oversight.
Alison Barkoff, who led the Administration for Community Living under President Biden, told Disability Scoop that states should use the extra time to build grievance systems that integrate with incident management.
Why this matters for providers and DSPs
The grievance system will eventually give people a formal way to complain about their service planning or settings, such as restricted visitors or community access. Because CMS may revise the rule, agencies should watch for a proposed change while reviewing their own complaint and incident processes.