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CMS Updates Work to Streamline SPAs, Section 1915 Waivers

The Centers for Medicare & Medicaid Services (CMS) on Aug. 16 released an informational bulletin with an update on the agency’s efforts to improve processing times for state plan amendments (SPAs) and Section 1915 waivers.

The release follows a Nov. 6, 2017, bulletin in which CMS committed to making review processes for SPAs and Section 1915 waivers more transparent, efficient, and less burdensome.

With feedback from stakeholders, including state Medicaid directors, CMS developed an improvement strategy to decrease processing times. As a result, the agency cites improvements in the median approval time for SPAs and Section 1915 waivers from calendar year 2017 to the first quarter of 2018.

CMS also plans long-term process improvements, including piloting an expedited review process for certain SPAs and Section 1915 waivers and creating an escalation review path for SPAs and Section 1915 waivers at risk of disapproval.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.

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