PT: CMS Seeks To Streamline Medicaid Waivers For States

Monday, November 6, 2017

NYAPRS Note: An update from this morning’s posting on federal Medicaid policy. Good news is that CMS will be streamlining its oversight over state Medicaid initiatives. Nothing yet about the possibility of work requirements.

CMS Seeks To Streamline Medicaid Waivers For States
By Rachana Pradhan November 6, 2017 With help from Brianna Ehley

CMS, the federal Medicaid agency today issued guidance on its plans to ease the process for Medicaid 1115 waivers and state plan amendments, something state officials in both parties frequently criticize as an excruciating back-and-forth with the federal government. Some highlights:
- CMS is cutting the number of reports states have to submit to the federal government to monitor Section 1115 demonstrations, with the guidance stating that fourth quarter reports will be combined with annual ones. The frequency of other reports could also be reduced if demonstrations are long-standing and have already been "rigorously evaluated and determined successful."
- The federal government may grant extensions of up to 10 years for routine, non-complex waivers. CMS is also developing parameters to expedite approvals for proposals that are "substantially similar" to waivers already granted in other states.
-States will be eligible earlier to receive waiver extensions under a "fast track" process if the demonstration meets certain criteria, including that a state isn't proposing major or complicated changes.
See the guidance on 1115 waivers and a separate document on securing Medicaid state plan amendments.