Section 1115 Medicaid waivers drive a large and growing share of Medicaid spending. Currently, 46 states and D.C. operate some or all of their Medicaid programs under section 1115 demonstration authority. Many of these waivers promote coverage; others undermine it, and in the process, the Medicaid program. Unfortunately, the federal regulations governing section 1115 waivers […]
The Biden CMS inherited a real waiver mess in Tennessee, but CMS may have found a path forward. CMS has asked the state to amend the most problematic parts of its section 1115 demonstration known as TennCare III, so that the TennCare program can continue. Just as importantly, to its credit (and unlike some other […]
Vermont is one of ten states that don’t use risk-based Medicaid managed care. It’s not that Vermont isn’t interested in risk-based managed care. The state is very interested—so long as it is the managed care organization (MCO). The state made its case to CMS in its application to extend its section 1115 demonstration beyond June […]
The drama over Texas’ Section 1115 Medicaid waiver has come to a somewhat surprising and precipitous close. On April 22nd, 2022 the Biden Administration decided to stop fighting the litigation brought by Texas Attorney General Paxon to reinstate the terms of the Trump Administration’s waiver approval issued on January 15, 2021 (i.e. just a few […]
If you blinked at just the wrong moment last week, you might have missed that the Supreme Court erased several years of critical Medicaid law with just one 113-word order. Poof! On Monday, April 18th, the Supreme Court issued an order in the cases on appeal reviewing the legality of approvals of work requirements by […]
Texas Expects to Get, But Not Give, Notice The Biden Administration came to town with clear intentions to review some of the waiver agreements that the Trump Administration had authorized – most notably on work requirements. We and others had urged the Trump Administration to reconsider the January 15th demonstration approval in Texas in light […]
