Letter from Cindy Mann, Director, Centers for Medicare & Medicaid Services (CMS) about changes to Section 1915(i) of the Social Security Act which take effect on October 1, 2010. These changes include revised and new 1915(i) provisions for removal of barriers to offering home and community-based services (HCBS) through the Medicaid State plan. The letter provides states guidance on important changes to the law.