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Understanding Medicaid Section 1115 Waivers: A Primer for ...

Understanding Medicaid Section 1115 Waivers: A Primer for State Legislators1 NATIONAL CONFERENCE OF STATE LEGISLATURESI ntroductionWhile the national health care debate continues, states continue to design and improve their Medicaid programs working within the flexibility allowed under existing federal Medicaid law, using longstanding tools such as Section 1115 waivers to best meet their state s unique needs. This Primer is designed to make that job easier by answering the eight most common and consequential questions about Medicaid Section 1115 waivers. In this booklet, we review some of the most important recent and proposed changes. We conclude with information about where to find information about the changing status of waiver applications, and offer resources and tools that can help state policymakers understand and engage in the waiver Eight Questions Regarding Section 1115 Waivers: 1. What are Section 1115 waivers? ..42. What is currently required for Section 1115 waiver approval?

Access Commission.1 As shown in the map on facing page, use of Section 1115 waivers among states is common. 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.2

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