Medicaid waivers for 11 more states approved by CMS

March 24, 2020

As part of its ongoing response to the Novel Coronavirus (COVID-19), the Centers for Medicare & Medicaid Services (CMS) approved 11 more state Medicaid waiver requests under Section 1135 of the Social Security Act, bringing the total number of approved Section 1135 waivers for states to 13.

The waivers “offer states new flexibilities to focus their resources on combatting the outbreak and providing the best possible care to Medicaid beneficiaries in their states. These waivers support President Trump’s commitment to operating a COVID-19 response that is locally executed, state managed and federally supported,” according to a press release issued late Monday night by CMS.

The waivers offer relief on a number of fronts, such as prior authorization and provider enrollment requirements, suspending certain nursing home pre-admission reviews, and facilitating reimbursement to providers for care delivered in alternative settings due to facility evacuations.  

Today’s approved waivers include the following states:

Examples of waivers available under section 1135 of the Act include:

  • Temporarily suspend prior authorization requirements;
  • Extend existing authorizations for services through the end of the public health emergency;
  • Modify certain timeline requirements for state fair hearings and appeals;
  • Relax provider enrollment requirements to allow states to more quickly enroll out-of-state or other new providers to expand access to care, and
  • Relax public notice and submission deadlines for certain COVID-19 focused Medicaid state plan amendments, enabling states to make changes faster and ensure they can be retroactive to the beginning of the emergency.

These section 1135 waivers are effective March 1, 2020 and will end upon termination of the public health emergency, including any extensions. Last week, CMS approved COVID-19 related state Medicaid section 1135 waiver requests for Florida and Washington.

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