On March 17, 2021, HHS notified Arkansas and New Hampshire officials that it was withdrawing its approval of demonstration projects which had permitted those states to impose work requirements as a condition for eligibility...more
On March 11, the Supreme Court removed the dispute over Medicaid work requirements, which was previously scheduled for March 29, from its argument calendar. It is worth noting that the Court did not issue a ruling with its...more
While CMS has been relatively quiet as of late from a public-facing perspective as it waits for new political leadership to arrive (including newly announced CMS Administrator, Chiquita Brooks-LaSure), a recent review by your...more
On Friday, February 12, the Centers for Medicare and Medicaid Services (CMS) took a first step to ending Medicaid work requirements. Acting CMS Administration Elizabeth Richter sent letters to Medicaid Directors in states...more
CMS approved Georgia’s Section 1115 demonstration project to partially expand Medicaid coverage for adults not otherwise eligible for Medicaid coverage with incomes up to 95 percent of the Federal Poverty Line (FPL)—short of...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
The Trump administration has issued sweeping new Medicaid guidance, continuing its efforts to cap federal Medicaid funding. The new policy relies on untested legal theories to implement the fundamental “bargain” of block...more
On Thursday, Jan. 30, the Centers for Medicare and Medicaid Services (CMS) released the Healthy Adult Opportunity initiative, long-awaited guidance that would enable states to convert Medicaid funding into a block grant for...more
On December 12, 2019, CMS approved South Carolina’s proposal for a demonstration project that would add work, or community engagement, requirements as part of the eligibility determinations for the state’s Medicaid plan. ...more
On November 4, 2019, Georgia officials announced a proposed Section 1115 demonstration waiver, referred to as the “Georgia Pathways Health Waiver,” to expand Georgia’s Medicaid program eligibility for non-disabled adults. If...more
Introduction - In March 2019, the Centers for Medicare & Medicaid Services (CMS) issued detailed guidance for states on the monitoring and evaluation of “eligibility and coverage” Section 1115 Medicaid demonstrations. The...more
On April 10, 2019, the Department of Justice filed notices appealing two District Court rulings that struck down Medicaid work requirements in both Kentucky and Arkansas to the U.S. Court of Appeals for the District of...more
To date, Section 1115 waivers that condition Medicaid eligibility on beneficiaries’ meeting work and community engagement (CE) requirements have been approved by the Centers for Medicare & Medicaid Services (CMS) for eight...more
In 2014, Arizona expanded Medicaid to the new adult group. Following the expansion, Arizona submitted, and CMS approved, an 1115 waiver extension to create the Choice, Accountability, Responsibility, Engagement (CARE)...more
On November 20, 2018, Virginia submitted an application to CMS for a Section 1115 demonstration program entitled Virginia COMPASS (Creating Opportunities for Medicaid Participants to Achieve Self-Sufficiency). The application...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
We have continually provided updates on the application and approvals of Medicaid 1115 waivers that include work requirements. One such approved waiver is the Arkansas Works Program. As we previously noted, Arkansas became...more
On August 10, 2018, South Dakota submitted a five-year Section 1115 waiver application to CMS to implement the South Dakota Career Connector program. The waiver application proposes work requirements for certain Medicaid...more
In January 2018, CMS issued new guidance allowing states to impose work requirements as a condition of Medicaid eligibility through the use of Section 1115 Medicaid demonstration waivers. These waivers allow states to test...more
In a previous blog, we reviewed pending and approved 1115 waivers in 11 states. These reviews provide an overview of 1115 waiver applications, including a focus on work requirements, lock-outs, changes in coverage structures,...more
As of March 2018, there are twenty-four Medicaid 1115 waivers pending CMS approval. Medicaid 1115 waivers, Research and Demonstration Projects, give states experimental, pilot, or demonstration projects likely to assist in...more
The Centers for Medicare & Medicaid Services (CMS) started the year with a bang, issuing guidance on January 11, 2018, in support of Medicaid demonstration projects that condition coverage on beneficiary participation in work...more
Today (January 11, 2018), CMS released a Letter to Medicaid Directors outlining guidance that work requirements can be used as a basis for eligibility for certain adult Medicaid beneficiaries through 1115 waivers. Medicaid...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
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