Policy Issues

1115 Waivers

 
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When a State wants to use its Medicaid program in a way that does not fit the requirements of the Social Security Act, they will frequently turn to Section 1115 of the Act which allows States to seek a waiver of limiting requirements.

For example, States have used Section 1115 Research and Demonstration waivers to address

• patient freedom of choice
• limited length of patient lock-in to managed care providers
• 90-day retroactive Medicaid eligibility
• service comparability
• limitations on groups of Medicaid eligibles
• FQHC services as mandatory Medicaid services
• and PPS reimbursement to FQHCs for services to new groups of eligibles created under the waiver.

Click Here for the latest Medicaid § 1115 Waiver and Post Deficit Reduction Act (DRA)State Plan Amendments report and matrix - State Policy Report #22. 

WWW URL IconCenters for Medicare and Medicaid Services (CMS) waiver page, which contains state-by-state information on current and pending waivers

The Role of Section 1115 Waivers in Medicaid and CHIP: Looking Back and Looking Forward - The Kaiser Commission on Medicaid and the Uninsured, Issue Paper, March 2009. 

THE FOLLOWING DOCUMENTS PROVIDE DETAILED EXAMINATION 1115 WAIVER:

06-16-2009   Current FQHC-Specific Language in Medicaid 1115 Waivers and SPAs - State Policy Report #24 (84kb)

12-01-2007   1115 Waiver and State Plan Amendment Matrix - State Policy Report #19 (December 2007) (317kb)

12-01-2007   1115 Waiver Regulations (954kb)

12-01-2007   Summary of legal aspects (71kb)

THE FOLLOWING DOCUMENTS EXAMINE 1115 WAIVERS BY SPECIFIC STATE:

State Concept Papers
01-01-2004   Connecticut (2078kb)

06-01-2005   Georgia (658kb)

10-01-2006   Louisiana (768kb)

12-01-2005   Nebraska (539kb)

11-01-2004   New Hampshire (945kb)

06-01-2006   Oklahoma (549kb)

09-01-2006   South Carolina (360kb)

Pending Applications:
06-01-2006   Montana (386kb)

06-01-2005   Michigan (462kb)

New Approved Waivers
03-01-2006   Arkansas (159kb)

09-01-2005   California (103kb)

10-01-2005   Florida (134kb)

01-01-2006   Hawaii (1386kb)

07-01-2005   Iowa (1556kb)

10-01-2005   Kentucky Partnership (201kb)

01-01-2005   Massachusetts (1008kb)

10-01-2006   New York (398kb)

10-01-2005   Oklahoma (52kb)

01-01-2002   Oregon (718kb)

06-01-2005   Tennessee (736kb)

09-01-2005   Vermont (292kb)

Approved State Plan Amendments:
06-06-2008   Maine (7kb)

06-06-2008   Missouri (21kb)

06-06-2008   Pennsylvania (11kb)

06-06-2008   South Carolina (17kb)

06-06-2008   Virginia (20kb)

06-01-2005   West Virginia (235kb)

06-06-2008   Wisconsin (72kb)

Benchmark
06-06-2008   Idaho (26kb)

06-06-2008   Idaho (105kb)

06-06-2008   Kansas (623kb)

06-06-2008   Kentucky (978kb)

Archives
12-07-2007   Emerging Issues in Medicaid and SCHIP #1: Tennessee’s New Definition of “Medically Necessary” (370kb)

07-01-2005   Emerging Issues in Medicaid and SCHIP #2: Medicaid Reform: Privatization and Health Savings Accounts (169kb)


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