This issue brief examines the CMS targeted case management rule, issued December 4, 2007, in the context of people with complex health needs who receive community-based care management services. Following a brief overview of the case management amendments contained in the Deficit Reduction Act, this analysis summarizes the key elements of the CMS regulation and considers its implications for specialized services, providers, and programs.  The House recently approved legislation to delay the implementation of the TCM rule, as well as six other Medicaid regulations, until April 2009. Similar legislation is pending in the Senate.