What MDH Just Said: The HCBS Cost Survey Is Mandatory — Due September 30

If your agency provides Medicaid home- and community-based services in Maryland — personal assistance, residential habilitation, day services, and more — check your inbox for a July 2 email from [email protected]. It’s not optional reading. In the state’s own words:

“If you have received this email, your participation in the cost survey process is mandatory.”

Who this applies to

Providers in Maryland’s HCBS programs — including the Community First Choice (CFC), Community Personal Assistance Services (CPAS), Community Options Waiver, Autism Waiver, and Brain Injury Waiver programs. If you bill personal assistance, habilitation, respite, nurse monitoring, or related codes and the email landed in your inbox, you’re in scope.

What this actually is

In May 2024, the federal government finalized the Ensuring Access to Medicaid Services rule (CMS-2442-F) — the “Access Rule.” Among other things, it pushes states to prove their payment rates are adequate and requires that a large share of payments for personal-care-type services reach direct care workers’ compensation. To comply, Maryland hired Myers and Stauffer LC to collect real cost data from providers: your wages, benefits, revenue by procedure code, staffing patterns, and operating costs for the fiscal year that ended June 30, 2026.

The survey itself is a macro-enabled Excel workbook (download link is in the July 2 email — email attachments were skipped because filters eat macro files). It customizes itself: you mark the services you bill, and only the relevant tabs stay active.

The dates that matter

• Due: Wednesday, September 30, 2026, submitted through Myers and Stauffer’s secure portal (register your account at dsh.mslc.com now — don’t wait until the deadline week).
• Five free technical-assistance webinars, all recorded for later viewing: July 21 (1pm) · August 5 (10am) · August 20 (3:30pm) · September 2 (12:30pm) · September 15 (3pm). Registration links are in the same email.

The one number to know before you submit

Buried in the workbook is a tab called “Access Rule.” It calculates the percentage of your Medicaid revenue that went to direct care worker compensation — wages, bonuses, payroll taxes, health insurance, retirement. That’s the number the federal 80% direct-care-compensation standard will eventually judge personal-care services against. Compute it before you file so you know what story your own books tell.

What to do about it

1. Register your portal account at dsh.mslc.com this week — it’s the step people forget until September 29.
2. Sign up for a webinar (or plan to watch a recording).
3. Close your books for July 1, 2025 – June 30, 2026. The survey requires a P&L or trial balance for that exact period as supporting documentation.
4. Start pulling payroll by role — the survey wants direct care worker wages, overtime, and bonuses separately from clinical supervisors and admin staff, plus the employer side of taxes, workers’ comp, health insurance, and retirement.
5. Pull Medicaid revenue by procedure code for every service you bill.
6. Gather the small buckets people miss: direct care worker mileage, PPE costs, and training costs (the trainer and materials — not the trainee’s wages).

Why filing well matters (beyond “it’s mandatory”)

This data becomes the rate study — the numbers Maryland uses to set what these services pay going forward. If agencies like yours don’t file, or file sloppily, the rates get built from everyone else’s cost structure. This is the rare state paperwork that’s also a vote on your own reimbursement.

Questions about the survey go to [email protected].

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The Care Insider is not affiliated with or endorsed by the Office of Health Care Quality or the Maryland Department of Health. This is operator-to-operator plain-language explanation, not legal advice — always read the original guidance.