42 CFR §435.217
The agency may provide Medicaid to any group or groups of individuals in the community who meet the following requirements:
- (a)The group would be eligible for Medicaid if institutionalized.
- (b)In the absence of home and community-based services under a waiver granted under part 441—
- (1)Subpart G of this subchapter, the group would otherwise require the level of care furnished in a hospital, NF, or an ICF/IID; or
- (2)Subpart H of this subchapter, the group would otherwise require the level of care furnished in an NF and are age 65 or older.
- (c)The group receives the waivered services.