The Center for Medicaid and CHIP Services (CMCS) released a State Medicaid Director Letter to facilitate the continuation of home and community-based services (HCBS) waiver flexibilities requested by states during the COVID-19 Public Health Emergency (PHE). The letter automatically amends the expiration date of approved Appendix K provisions to be the later of November 11, 2023 or the effective date of amendments to underlying 1915(c) waivers to incorporate relevant PHE flexibilities. This ensures states, providers, and enrollees that there will be no disruption to the HCBS delivery system for PHE flexibilities the state requests to incorporate into ongoing HCBS waiver programs.