Utah joins a growing list of states with approval to implement Medicaid work requirements, but it is the first state to limit enrollment to individuals below the federal poverty level and implement a spending cap.

The court ruled that the Department of Health and Human Services overstepped its authority and failed to show that work requirements would help promote the purpose of the Medicaid program

The tools and guidance aim to help states monitor and evaluate the effects of Section 1115 waiver demonstrations, including those with work and community engagement requirements and those that combat substance use disorder.

Ohio’s waiver requires beneficiaries ages 18 to 49 who are eligible through Medicaid expansion to work or participate in other community engagement activities for at least 80 hours a month.

A Centers for Medicare & Medicaid Services bulletin notes that states can cover non-opioid pain management therapies using several Medicaid authorities, including Section 1945 health home benefits, 1915(i) state plan amendments, Section 1115 demonstrations, and managed care strategies.

The waiver requires beneficiaries ages 19 to 49 who are eligible through Medicaid expansion to work or participate in community engagement activities for at least 80 hours a month.

Maine and Michigan join five other states to receive approval for Medicaid work requirements; unlike most other states, Maine's work requirements will apply to both existing beneficiaries and those newly eligible through expansion.

The waiver permits federal reimbursement for short-term stays in institutions for mental disease for individuals with substance use disorders.

The state’s waiver initially was approved in May, but required a second approval to extend beyond Dec. 31.

The U.S. District Court for the District of Columbia vacated the previous approval, saying the administration failed to adequately assess the waiver's impact on Medicaid’s core objective: to provide health care coverage for beneficiaries.

A new demonstration opportunity, which can be carried out through Section 1115 waivers, would allow states to receive reimbursement for services at institutions for mental disease for individuals with serious mental illness or serious emotional disturbance.

Wisconsin is the fifth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

The expansion is expected to give up to 400,000 additional Virginians access to the program; the Centers for Medicare & Medicaid Services has not announced a decision on the state's Section 1115 waiver, which includes work requirements.

The letter marks the first time the Centers for Medicare & Medicaid Services has clearly described its budget neutrality calculation and represents its attempts to streamline the waiver process and control costs.

What comes next after the June 29 court ruling that vacated the U.S. Department of Health and Human Services approval of a Section 1115 waiver that allowed Kentucky to impose community engagement and work requirements on Medicaid beneficiaries.

The decision strikes down the state's overall Section 1115 waiver, which included community engagement and work requirements, but it upholds as a separate waiver a portion allowing Medicaid reimbursement for substance use disorder treatment in institutions for mental disease.

This year's Medicaid and CHIP Payment and Access Commission report focuses on the high cost of prescription drugs and the opioid epidemic.

New Hampshire is the fourth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

Reports by the National Academy of State Health Policy and the Medicaid and CHIP Payment and Access Commission point to new trends, including increased focus on reform, new financing mechanisms, and standardized evaluation.

A new policy brief examines Centers for Medicare & Medicaid Services guidance on work and community engagement requirements for Medicaid eligibility and outlines recently approved section 1115 waivers in Kentucky, Indiana, and Arkansas.

The three-pronged approach aims to reduce drug demand, cut off the flow of illicit drugs domestically and internationally, and expand opportunities for proven addiction treatments.

Under the approved waiver, Arkansas Medicaid beneficiaries ages 19 to 49 beginning June 1 must work or participate in community engagement activities for 80 hours per month to maintain their eligibility.

The Centers for Medicare & Medicaid Services announced the community engagement initiative, often referred to as work requirements, in a Jan. 11 letter and a frequently asked questions document.

The waiver extensions fund Texas' uncompensated care pool and delivery system reform incentive payment program and provide family planning services for low-income individuals in Mississippi for 10 years.

In response to the request for information, the association encouraged flexibility and a focus on hospitals treating high numbers of complex patients.

In a speech to the National Association of Medicaid Directors, Administrator Verma also announced an initiative to create scorecards for Medicaid and CHIP outcomes.

CMS announced a new streamlined process to encourage state innovation through demonstrations and approved new demonstrations for New Jersey and Utah.

The five-year demonstration project, beginning Jan. 1, 2018, aims to strengthen substance use disorder care for state Medicaid beneficiaries.

The decision extends by five years the state's demonstration of a capitated Medicaid managed care program and a low-income pool to provide support for the safety net.

A publicly released set of slides describes dramatic restrictions to CMS' budget neutrality policy for Section 1115 waivers.

In this new policy brief, America's Essential Hospitals examines Section 1115 waivers that use a market-based approach to expanding Medicaid.

The letter affirms their desire to improve the Medicaid program and the vulnerable people it serves and to ensure the program provides value to taxpayers.

A CMS bulletin reminds states that Medicaid funds can be used for prevention, diagnosis, and treatment of the Zika virus.

States may apply for a Section 1115 Medicaid waiver to support innovative care delivery for substance abuse disorder. SAMHSA, HRSA to also offer funding opportunities.

Proposed renewals must be for demonstrations that are working effectively and have no major or complex policy changes. Certain waivers that use the enhanced FMAP are ineligible.

MACPAC's report to Congress touts potential of DSRIP programs to transform Medicaid reimbursement and improve health outcomes, also addresses the challenge and calls for clear and consistent federal guidance.

Calls for HHS to establish specific criteria for approval, document how programs will address the health of low-income populations, and ensure federal funding is not duplicated.

In an April 28 letter, the association urged CMS to adopt a holistic view of how payment mechanisms impact essential hospitals, including sustainable base payment rates, Medicaid waivers to address uncompensated care, and DSRIP waivers.

Report includes potential impact if CHIP was to expire, Section 1115 waivers used to expand Medicaid coverage, and other aspects of Medicaid payment policy.

GAO found that HHS did not ensure budget neutrality when approving Arkansas' Medicaid expansion waiver. Issues include lack of data to corroborate state assumptions and state flexibility to expand spending limits.

Using case studies and related research, America's Essential Hospitals describes how waiver-based incentive programs support essential hospitals' delivery system reform.

America’s Essential Hospitals released a policy brief that discusses approaches to extending the reach of health care transformation through Medicaid waiver incentive programs.

CMS will not approve SPAs that include non-bona fide donations as a portion, or all, of the non-federal share of Medicaid payments. Payment methodologies contingent upon the receipt of a non-bona fide donation would also be grounds for disapproval of an SPA.

Section 1115 projects give states additional authority to design, improve Medicaid and CHIP programs