1115 Medicaid Demonstrations

6 Fixes to Improve Medicaid Coverage Access Amid COVID-19

by Kelsey Waddill

New York’s experience during the Great Recession could inform its approach to coronavirus Medicaid during the pandemic, a recent report from the United Hospital Fund suggested. For more...

OK Submits Healthy Adult Opportunity Waiver to Expand Medicaid

by Jacqueline LaPointe

Oklahoma is the first state to officially request a Healthy Adult Opportunity demonstration waiver to expand its Medicaid program using the new block grant system. According to an announcement from...

How to Improve Medicaid Member Engagement, Care Coordination

by Kelsey Waddill

California’s whole person care 1115 Medicaid demonstration waiver illustrates the challenges Medicaid programs face in providing care coordination for Medicaid beneficiaries and offers insight on...

CMS Releases Four Medicaid Waiver Templates To Fight Coronavirus

by Kelsey Waddill

On March 22, the Trump Administration released materials to guide Medicaid and CHIP programs to effectively orient and pursue coronavirus relief efforts. For more coronavirus updates, visit our...

3 Forms of Medicaid Expansion that Can Increase COVID-19 Coverage

by Kelsey Waddill

Medicaid expansion is key to securing national access to care for the new coronavirus and the federal government can and should support state programs for increasing COVID-19 coverage, according...

Block Grant Complexity, Vagueness May Limit Medicaid Uptake

by Kelsey Waddill

Healthy Adult Opportunity (HAO), a section 1115 Medicaid demonstration that creates a non-mandatory block grant for certain Medicaid populations, could require an expansion state to generate Medicaid...

Appeals Court Strikes Down AR Medicaid Work Requirements

by Kelsey Waddill

The US Court of Appeals dealt a blow to Medicaid work requirements when the judges presiding over Gresham v Azar upheld the lower court decision to invalidate Arknsas’s Medicaid work...

HIV Patients Could Lose Coverage Under Medicaid Work Requirements

by Kelsey Waddill

If applied nationwide, Medicaid work requirements could be used to target 13 percent of non-SSI, non-dual, non-elderly Medicaid adults suffering from HIV who would not be compliant with normal working...

CMS Releases Medicaid Block Grant With Drug, Benefit Flexibilities

by Kelsey Waddill

Updated 1/30/20: This article has been updated to include a statement from Avalere. The Trump Administration announced a Medicaid block grant initiative called Healthy Adult Opportunity, which serves...

HHS and CMS Sued for Work Requirements in MI Section 1115 Demo

by Kelsey Waddill

HHS and CMS are being sued over Michigan’s section 1115 demonstration waiver defining the state’s new work requirements. The plaintiffs, who include individuals who would be impacted by...

CMS OKs Demo to Expand Behavioral Health Treatment in Medicaid

by Samantha McGrail

CMS approved a Section 1115 demonstration that will broaden behavioral health treatment for Medicaid beneficiaries living in the District of Columbia who have been diagnosed with serious mental illness...

KY Medicaid Work Requirements May Cause Uninsurance If Reinstated

by Kelsey Waddill

If Kentucky, the first state to pass Medicaid work requirements, appeals to reinstate the rule, it may face the same confusion and rise in uninsurance that Arkansas experienced, researchers from the...

CMS OKs AK’s Section 1115 Demo, Expands Behavioral Healthcare Services

by Kelsey Waddill

CMS approved the second part of Alaska’s Section 1115 Medicaid demonstration waiver addressing behavioral healthcare. The first part, addressing substance abuse care, was approved in November...

Medicaid Expansions Improve Coverage, Quality of Care, Economy

by Kelsey Waddill

Medicaid expansions under the Affordable Care Act (ACA) have improved coverage, access to care and coverage, and the economy, according to a recent Kaiser Family Foundation report. “The...

IN 1115 Waiver Amendment Helps Members Transition to Commercial Plans

by Kelsey Waddill

Indiana submitted an application for an amendment to the state’s Healthy Indiana Plan Section 1115 Demonstration that would help transition members off of the HIP and into commercial coverage....

Judge Strikes Down New Hampshire’s Work Requirements

by Kelsey Waddill

New Hampshire’s proposal to create work requirements for Medicaid went the same path as Kentucky’s and Arkansas’ did earlier this year, with a federal judge striking down the Section...

CMS Approves 2 Medicaid Demos to Tackle Substance Abuse Disorders

by Kelsey Waddill

CMS recently approved two section 1115 demonstration waivers that will allow Minnesota and Nebraska to improve and expand upon their Medicaid institutions for mental diseases (IMDs) over the course of...

Study Links AR Medicaid Work Requirements to Coverage Losses

by Kelsey Waddill

Arkansas’s decline in Medicaid coverage has been linked to the state’s implementation of a work requirement for Medicaid enrollees between 30 and 49 years old, according to a study approved...

Transparency Limited for Medicaid 1115 Demonstration Waivers

by Sara Heath

CMS and state Medicaid agencies are not always transparent about the consequences of 1115 demonstration waivers, specifically about how various demonstrations might impact beneficiaries, according to a...

CMS Seeks New State Waivers to Boost Individual Insurance Market

by Jessica Kent

CMS is issuing a request for information (RFI) asking states for ideas to develop State Relief and Empowerment Waivers to reduce costs in the individual insurance market. In a recent blog post, CMS...