S. 1989 modifies the Medicaid program to increase transparency and expand access to home and community-based services (HCBS) for people with disabilities. The bill requires states to publicly report detailed information about their HCBS programs starting in 2028, including waitlist management practices, service types, average wait times, and how many authorized service hours are actually delivered to patients. It also allows states to extend HCBS coverage to individuals who meet disability standards under federal law but haven't yet been formally determined to need institutional care, provided this expansion doesn't delay services for existing eligible recipients. Additionally, the legislation directs the Department of Health and Human Services to issue guidance by January 2026 allowing up to 60 days of interim HCBS coverage while states finalize a patient's full care plan. The bill primarily affects states administering Medicaid programs and individuals with disabilities seeking home and community-based support services, though it does not specify new federal funding amounts.
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