News & Analysis as of

Health Insurance 1115 Waivers

Manatt, Phelps & Phillips, LLP

D.C. Court Strikes Down Indiana 1115 with Premiums and Coverage Restrictions

On June 27, the D.C. District Court struck down CMS’ 2020 approval of a 10-year renewal for the Healthy Indiana Plan (HIP) 2.0 Medicaid Section 1115 demonstration (Rose v. Becerra). In addition to the atypical 10-year...more

Manatt, Phelps & Phillips, LLP

CMS Approves Montana’s Reentry Services, Contingency Management, and Tenancy Supports 1115 Waiver

On February 26, 2024, Montana received Centers for Medicare and Medicaid Services (CMS) approval to provide contingency management, tenancy supports, and Reentry Initiative services under its Section 1115 Healing and Ending...more

Manatt, Phelps & Phillips, LLP

New York State’s Approved Health Equity 1115 Waiver Amendment: Summary of Key Provisions

On January 9, 2024, the Centers forMedicare and Medicaid Services (CMS) approved New York’s request to amend its Medicaid section 1115 demonstration waiver, “Medicaid Redesign Team.”1 New York State announced that the...more

Epstein Becker & Green

An Overview of the CMS Approved New York 1115 Medicaid Waiver

Epstein Becker & Green on

On January 9, 2024, the Center for Medicare and Medicaid Services (CMS) sent a letter to New York’s Medicaid director approving New York’s Section 1115 Waiver amendment, which the state submitted for approval on September 2,...more

Manatt, Phelps & Phillips, LLP

CMS Approves WA’s 1115 Waiver with Health-Related Social Needs & Justice-Involved Initiatives

On June 30, 2023, the Centers for Medicare & Medicaid Services (CMS) approved Washington’s five-year Section 1115 demonstration renewal, the Medicaid Transformation Project 2.0 (MTP 2.0 or Demonstration). Through its renewed...more

Manatt, Phelps & Phillips, LLP

[Webinar] Medicaid Coverage Opportunities for Justice-Involved Populations: CMS Guidance and States’ Approaches - July 13th, 3:00...

Individuals leaving incarceration have disproportionately higher rates of physical and behavioral health diagnoses and are at higher risk for injury and death compared with people who have not been incarcerated. Race...more

Manatt, Phelps & Phillips, LLP

CMS Approves First-in-Nation Justice-Involved Reentry Section 1115 Demonstration

The Big Picture - On January 26, 2023, the Centers for Medicare & Medicaid Services (CMS) approved California’s request to amend the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration. A...more

Manatt, Phelps & Phillips, LLP

CMS Approves Groundbreaking Section 1115 Demonstrations

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

Manatt, Phelps & Phillips, LLP

Centering Health Equity in Medicaid: Section 1115 Demonstration Strategies

Longstanding structural racism and related health inequities experienced by people of color further laid bare by the COVID-19 pandemic have mobilized leadership in many states to take action on health equity. Structural...more

Manatt, Phelps & Phillips, LLP

Centering Health Equity in Medicaid Section 1115 Demonstrations: A Roadmap for States

Longstanding structural racism and related health inequities experienced by people of color further laid bare by the COVID-19 pandemic have mobilized leadership in many states to take action on health equity. Structural...more

Manatt, Phelps & Phillips, LLP

In Pursuit of Whole Person Health: Leveraging Medicaid Managed Care & 1115 Waivers to Address SDOH

Editor’s Note: In a new report, Manatt explores how states are using two key tools—Medicaid managed care contracts and 1115 waivers—to address the unmet social needs of people with Medicaid coverage. The findings have...more

King & Spalding

Trump Administration Approves Georgia’s Limited Expansion of Medicaid and Work Requiremen

King & Spalding on

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

Manatt, Phelps & Phillips, LLP

Utah Seeks Capped Spending, Partial Expansion with Enhanced Match

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

Sheppard Mullin Richter & Hampton LLP

Arkansas and Kentucky Halt Medicaid Work Requirements

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

Mintz - Health Care Viewpoints

The Buzz About Block Grants

With the recent scoop from Politico that the Trump Administration is considering giving states the ability to implement Medicaid block grants, there has been considerable speculation on what the Administration is planning....more

Mintz - Health Care Viewpoints

A Rundown of Recent State Action Relating to Medicaid Expansion

To date, 34 states (including D.C.) have adopted Medicaid expansion. Of the remaining 17 states, some are considering expanding Medicaid. States with recent activity relating to Medicaid expansion include Florida, Idaho,...more

Mintz - Health Care Viewpoints

What Lessons Can We Take From The Administration’s Refusal to Allow Idaho to Dismantle the ACA Marketplaces?

In early January, Idaho Governor Butch Otter signed an executive order (EO) directing the state’s Department of Insurance (DOI) to “seek creative options” to expand “access” to health insurance coverage for Idahoans. The EO...more

Bass, Berry & Sims PLC

CMS Guidance Paves Way for Medicaid Work Requirements

Bass, Berry & Sims PLC on

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

Manatt, Phelps & Phillips, LLP

Manatt on Health: Medicaid Edition: CMS Administrator Highlights Medicaid Policy Goals and New Guidance

Since assuming office last January, the Trump administration has signaled a shift in Medicaid policy. In early November, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma made the administration’s...more

Baker Donelson

Medicaid Forecast: Slower Enrollment Growth and Higher Spending Growth for FY 2017 – 2018: Results from a 50-State Medicaid Budget...

Baker Donelson on

On October 19, Kaiser Family Foundation and Health Management Associates hosted a joint briefing to release their 17th Annual 50-State Medicaid Budget Survey for state fiscal years (FY) 2017 and 2018. The survey highlights...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - May 2017 #2

Republican governors react to passage of the AHCA in the House; insurers begin to make Marketplace rate filing decisions despite continuing uncertainty; and expansion waiver evaluations in Indiana and Iowa find many enrollees...more

Manatt, Phelps & Phillips, LLP

Medicaid Family Planning Programs: Six Years Post-ACA Implementation

Editor’s Note: The Affordable Care Act (ACA) brought sweeping changes to the Medicaid program that have had profound implications for family planning coverage, services and providers. In particular, in the 17 states with...more

Manatt, Phelps & Phillips, LLP

Manatt on Medicaid: Maine Releases Draft Waiver Request Proposing New Eligibility Requirements

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

Manatt, Phelps & Phillips, LLP

Wisconsin Releases Draft Waiver Amendment Proposing New Eligibility Requirements

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

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - March 2017 #4

States react to the failure of the AHCA; the HHS Inspector General launches an investigation into the Trump Administration's suspension of Marketplace enrollment outreach efforts; and the Kansas Legislature sends a Medicaid...more

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