Colorado HCBS waivers move toward 2026 approval

Colorado’s Department of Health Care Policy and Financing (HCPF) is moving forward with updates to several Home and Community Based Services (HCBS) waivers that will shape how long-term supports are delivered beginning in 2026. These changes are part of a formal approval process with the Centers for Medicare & Medicaid Services (CMS) and are expected to result in newly approved HCBS waiver documents effective January 1, 2026.

HCBS waivers allow Colorado to offer Medicaid services beyond the standard state plan, with a focus on supporting individuals in their homes and communities rather than in institutional settings.

HCBS waivers in the CMS approval process

The following HCBS waiver programs are currently undergoing CMS review and approval:

• Developmental Disabilities (DD)

• Community Mental Health Supports (CMHS)

• Complementary and Integrative Health (CIH)

• Elderly, Blind, and Disabled (EBD)

• Children’s Extensive Supports (CES)

• Children’s Habilitation Residential Program (CHRP)

HCPF’s work is expected to culminate in updated, CMS-approved HCBS waiver documents that will govern how these programs operate beginning January 1, 2026.

What’s driving the 2026 waiver updates

To prepare for 2026 implementation, HCPF has been submitting amendments and renewals to its 1915(c) HCBS waivers for CMS review. These updates address core operational components across multiple waiver programs, including:

• Service definitions

• Eligibility criteria

• Rate methodologies

• Program structure and administration

Once approved, the updated HCBS waiver documents become the federally authorized framework that defines how services are delivered, billed, and monitored under each program.

Why the updated HCBS waivers matter

Colorado’s HCBS waivers fund critical services such as habilitation, residential supports, personal care, community integration, mental health services, respite, and more. When the updated waivers take effect on January 1, 2026, providers, case managers, individuals, families, and advocates will operate under the newest federally approved service rules.

In parallel, Colorado is transitioning certain services from HCBS waivers into the Community First Choice (CFC) State Plan benefit between 2025 and 2026. This shift will change how some personal care and support services are accessed and administered, adding another layer of operational change during this period.

With multiple waiver updates and service transitions occurring at the same time, providers will need to closely review the approved HCBS waiver documents once finalized. These changes can affect documentation requirements, service delivery expectations, billing processes, and compliance oversight as Colorado moves into 2026.