In addition to increased health and well-being and saving lives, the demonstration aims to accomplish several other essential goals, including improving coordination and communication between correctional systems, Medicaid systems, managed care plans, and community-based providers, as well as increasing investments in health care and related services. The Patient Protection and Affordable Care Act (ACA, P.L. State Waivers List | Medicaid The Medicaid and CHIP Payment and Access Commission is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Childrens Health Insurance Program (CHIP). Proposed Program Design | NC Medicaid By continuing on our website, you agree to our use of the cookie for statistical and personalization purpose. Washington's Apple Health and Homes treats housing as health care The approval process is more flexible for Section 1115 waivers than state plan amendments or program waivers, but the negotiation process can take several months or years. Section 1115 demonstration waivers provide states an avenue to test new approaches in Medicaid and generally reflect changing priorities from one presidential administration to another. The Administration recently provided more insight into how states can use Section 1115 authority to address enrollees social needs by approving waivers in four states (AR, AZ, MA, and OR) that include specified HRSN services for targeted populations; these HRSN initiatives encompass a small share of the overall Medicaid population and Medicaid spending. The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is announcing a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately prior to their release to help them succeed and thrive during reentry. The Secretary can also permit federal financial participation for costs not otherwise matchable, allowing states to cover services and populations not included in the Medicaid state plan. PDF Application for a 1915(c) Home and Community- Based Services Waiver In particular: This page tracks approved and pending Section 1115 waiver provisions (including expansions and restrictions) related to eligibility, benefits, and social determinants of health and other delivery system reforms, once such waivers are posted to the State Waivers List on Medicaid.gov. In 2017, CMS administered new guidance for approving Section 1115 Waivers that focuses on SUD treatment in residential settings and requires states to meet certain goals and milestones to qualify for a waiver. Published: Nov 15, 2022. The Biden Administration has encouraged states to propose waivers that expand coverage, reduce health disparities, and/or advance whole-person care, including by addressing health-related social needs (HRSN). How States Apply; Transparency; 1115 Demonstration Monitoring & Evaluation; State Waivers List; 1115 Substance Use Disorder Demonstrations; Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations; Health Related Social Needs; Managed Care. Most waivers are approved for an initial five-year period, after which states can apply for a renewal (typically three years) to continue operations. Section 1915(c) of the Social Security Act authorizes the . Continuous enrollment in Medicaid, which was required by federal law as a condition of states receiving enhanced federal matching funds during the COVID-19 public health emergency, has focused attention on the value of stable coverage. The American Rescue Plan Act (ARPA) gave states the option to extend postpartum Medicaid coverage from the federal minimum of 60 days to a full 12 months by submitting a state plan amendment, a less rigorous and time-consuming process than the section 1115 demonstration waivers states have previously used to extend postpartum coverage. Services to amen d the Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver. Within each states DSRIP program, the regional structure and organizational authority varies greatly, from individual hospital systems to complex networks of clinical and community-based providers. based on clinical and social risk factors, meaning that these services are not for everyone in the Medicaid program. The Medicaid Reentry Section 1115 Demonstration Opportunity will allow states to cover a package of pre-release services for up to 90 days prior to the individuals expected release date that could not otherwise be covered by Medicaid due to a longstanding statutory exclusion that prohibits Medicaid payment for most services provided to most people in the care of a state or county carceral facility. As of September 2017, 33 states had at least one approved 1115 waiver and 18 states had one or more waivers pending approval by the Centers for Medicare & Medicaid Services (CMS), according to a 2017 Kaiser Family Foundation report. The U.S. Department of Health and Human Services (HHS) has discretion to approve these demonstration, and, as seen from the history of work-requirement waivers, each administration develops its own waiver policies and . An official website of the United States government New guidance can help people at high risk of substance use disorders and other health conditions get the care they need, especially as they transition from incarceration back to the community. This proposed rule would revise our regulations on the counting of days associated with individuals eligible for certain benefits provided by section 1115 demonstrations in the Medicaid fraction of a hospital's disproportionate patient percentage. Status of State Actions to Extend Postpartum Medicaid Coverage PDF CMS Manual System - Centers for Medicare & Medicaid Services The waivers for these states vary significantly. An official website of the United States government. States may define eligibility for HRSN services, subject to CMS approval. The federal funding share is 66% to a maximum of $2 million for the duration of the project. Although trending towards similar goals, DSRIP has been approached differently state by state, especially as the programs have evolved and adapted learnings from other states. Benchmark Standards in Effect on December 1, 2009. This is an essential step for advancing health equity in our nation, and we encourage all states to take advantage of this new opportunity., Today, we reach a significant milestone in expanding access to health care in the Medicaid program, said CMS Administrator Chiquita Brooks-LaSure. Another eligibility-related Section 1115 issue to watch is pre-release services: eleven states (including AZ, MA, and OR) have requested waivers of the Medicaid inmate exclusion policy to provide pre-release coverage to certain incarcerated individuals. A lock ( The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 - KFF Under Section 1115, the HHS Secretary can waive almost any Medicaid state plan requirement under 1902 (with the exception of citizenship and requirements of another agency as in the case of ERISA) to the extent necessary to carry out a demonstration or experimental project furthering the goals of the program. PDF Notice Number 2023-179 Rule Number He-M 1401 1. Agency Name & Address Lock Effective April 27, 2012, in accordance with section 10201(i) of the Affordable Care Act that set forth transparency and public notice requirements for section 1115 demonstrations, states will need to include the following components in demonstration applications for CMS to consider the application submission complete for the purpose of initiating federal review. Share sensitive information only on official, secure websites. Section 1115 Waivers: An Overview and State by State Comparison Of the states explored in this brief, California was the first DSRIP program approved, followed by Texas, New York and then Washington, correlating roughly to the intricacy of each program. A federal government managed website by theCenters for Medicare & Medicaid Services.7500 Security Boulevard Baltimore, MD 21244. States. A section of the waiver reads: "The Commission, by resolution dated February 18, 1999, established a threshold to replace rather than repair or reconstruct CFAP Projects. Budget neutrality calculations are complicated and reflect a combination of per-capita and aggregate expenditures. Alabama Community Waiver Program | Medicaid CMS Approves Groundbreaking Section 1115 Demonstrations COVID-19 1115 Waiver Demonstration Template Healthy Adult Opportunity Section 1115 Demonstration Application Template The American Rescue Act Plan (ARPA) allowed states a temporary option to provide 12-month postpartum coverage, and the CAA made this option permanent. An official website of the United States government Improving health care transitions and addressing social determinants of health from case management to medication-assisted treatment for individuals after they have been released from carceral settings increases the likelihood that they may continue to receive crucial substance use disorder, mental health, and other health care treatment during this vital period. They are renewed for up to three years at a time. Official websites use .gov On January 31, 2020, the Secretary of Health and Human Services (HHS) declared a public health emergency, effective as of January 27, 2020, for the entire United States to aid the nations healthcare community in responding to the 2019 novel Coronavirus. Secure .gov websites use HTTPS Notable Section 1115 SDOH provisions approved prior to 2022 include: In addition to these and more recent approvals, 8 states are requesting CMS review of pending SDOH provisions. This includes a financial analysis of changes to the demonstration requested by the state, An evaluation report of the demonstration,including evaluation activities and findings to date, plans for evaluation activities during the extension period, and if changes are requested, identification of research hypotheses related to the changes and an evaluation design for addressing the proposed revisions, Documentation of the states compliance with the public notice process, with report of the issues raised by the public during the comment period and how the state considered the comments when developing the demonstration application. Read the report to see how your state ranks. Section 1115 Waiver Watch: How California Will Expand Medicaid - KFF If states decide to request a Section 1115 waiver, their cost sharing percentage is 34% as with regular child support program operations. SDOHare the conditions in which people are born, grow, live, work, and age that shape health; these include but are not limited to housing, food, education, employment, healthy behaviors, transportation, and personal safety.
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