Archive for: 1115 Waiver

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Insurance Coverage: Regulation

South Carolina 1115 Waiver Application Summary

On May 8, 2019, South Carolina submitted a new 1115 waiver application to the Centers for Medicare and Medicaid Services (CMS). The waiver includes work requirements, expands coverage for children, pregnant women and parents, and expands coverage for certain individuals with substance use disorders, who are chronically homeless or who are involved in the justice…

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Insurance Coverage: Regulation

Utah Per Capita Cap 1115 Waiver Summary

On May 31, 2019, Utah released its 1115 waiver proposal, “Per Capita Cap.” This waiver requests authority to implement the provisions of Senate Bill 96 “Medicaid Expansion Adjustments”, which passed during the 2019 Utah legislative session.  Provisions of the waiver include implementing a per capita cap, seeking enhanced Federal Medical Assistance Percentages (FMAP) for the…

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GAO Recommends CMS Improve Transparency Policy for Section 1115 Waivers

On May 17, the GAO released a report recommending an improved transparency policy for Section 1115 waivers.

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Insurance Coverage: Regulation

Utah Medicaid 1115 Waiver Summary

On June 22, 2018, Utah submitted an 1115 waiver amendment to CMS seeking to implement a partial and capped Medicaid expansion, as well as Medicaid work requirements for certain populations. Following that waiver amendment, on February 6, 2019, Utah submitted an additional 1115 waiver amendment lifting the Medicaid Institution for Mental Disease (IMD) exclusion for…

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