Editor’s Note: Section 1115 demonstrations (also called waivers) allow states to test new ways to operate their Medicaid programs, typically on matters related to eligibility, benefits and care delivery. Recently, the Centers...more
Section 1115 of the Social Security Act permits states to waive certain Medicaid statutory requirements through demonstration projects that advance state policy priorities and test innovations in their Medicaid programs....more
Four months after the Centers for Medicare & Medicaid Services (CMS) offered state Medicaid programs a new COVID-19 Section 1115 waiver opportunity, five of at least 20 applying states have received approval of their waiver...more
8/13/2020
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Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
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HCBS Waivers ,
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State Medicaid Programs
On May 11, 2020, New York State submitted a COVID-19 1115 waiver application to the Centers for Medicare & Medicaid Services (CMS), leveraging the opportunity to respond to the COVID-19 public health emergency (PHE) as...more
On May 31, 2019, Utah released a draft Section 1115 waiver application, the Per Capita Cap Demonstration, for public comment. The proposal seeks to create a new Section 1115 demonstration that, if granted, would break new...more
During the first half of 2018, the Centers for Medicare & Medicaid Services (CMS) granted four states—Arkansas, Indiana, Kentucky and New Hampshire—Section 1115 waivers permitting them to condition Medicaid coverage for...more
Medicaid’s Critical Role in Addressing the Opioid Crisis -
As the opioid crisis in the United States continues to deepen—with opioid overdoses claiming 42,000 lives in 2016—policymakers, providers, advocates and other...more
On October 6, the Centers for Medicare & Medicaid Services (CMS) approved West Virginia’s “Creating a Continuum of Care for Medicaid Enrollees with Substance Use Disorders” Section 1115 demonstration. West Virginia’s waiver,...more
Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary -
On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its...more
Indiana is seeking a three-year extension of its Healthy Indiana Plan (HIP) 2.0 Section 1115 demonstration. Through HIP 2.0, which the Centers for Medicare and Medicaid Services (CMS) approved in January 2015, Indiana...more
On May 12, 2017, Massachusetts released for public comment a proposed amendment to its MassHealth Section 1115 demonstration. MassHealth is a comprehensive demonstration that applies to the State’s entire Medicaid population....more
On April 25, 2017, the Maine Department of Health and Human Services released for public comment a draft Section 1115 waiver application to implement new eligibility and coverage requirements for MaineCare, the State’s...more
5/2/2017
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Affordable Care Act ,
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Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Fee-for-Service ,
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Healthcare Reform ,
Medicaid ,
Medicaid Work Requirements ,
Premiums
On April 19, 2017, Wisconsin released for public comment a proposed amendment to its BadgerCare Reform Section 1115 demonstration. BadgerCare Reform currently provides coverage to approximately 150,000 childless adults ages...more
4/24/2017
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Affordable Care Act ,
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Drug Treatment ,
Eligibility ,
Enrollment ,
Federal Poverty Line ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicaid Work Requirements ,
Mental Illness ,
Proposed Amendments ,
Trump Administration ,
Waivers