In response to an executive order, a new issue brief reviews four policy areas under Section 1115 demonstrations and their impact on Medicaid coverage and access to care. The brief notes all examined areas create barriers to enrollment and reduce coverage, leading to adverse health effects.

In its fourth interim final rule during the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services implements several measures to ensure timely access to a vaccine.

CMS issued several checklists and templates for state Medicaid and the Children's Health Insurance Program agencies to request regulatory relief and flexibility to respond to the COVID-19 outbreak.

This decision is the latest of several court cases invalidating work requirements policies in Medicaid; Utah now is the only state with these requirements in effect. It is unknown at this time if Michigan or the Department of Health and Human Services will appeal the decision.

In the unanimous decision, the United States Court of Appeals for the District of Columbia Circuit found that the Department of Health and Human Services failed to adequately assess the potential impact of work requirements on coverage under Arkansas' Section 1115 demonstration waiver.

CMS issued guidance outlining how states can receive a block grant or per-capita cap in exchange for additional administrative flexibility. Through a Section 1115 demonstration waiver, these new financing arrangements would apply to coverage of optional Medicaid patient populations.

Through this newly approved Section 1115 demonstration waiver, South Carolina becomes the first state to apply work requirements primarily to parents and caregivers.

CMS also approved a unique behavioral health transformation waiver for the District of Columbia that targets beneficiaries with serious mental illness or serious emotional disturbance.

The court ruled that the Secretary of Health and Human Services failed to adequately consider the effect of the work requirements on Medicaid coverage.

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

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.

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 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.

In an Aug. 16 bulletin, the agency announced it has decreased approval times for state plan amendments and Section 1915 waivers through a process improvement strategy and will continue efforts to streamline the waiver approval process.

The waivers allow each state to create a reinsurance program to lower premiums in the individual market; the waivers will take effect in 2019 and are approved through 2023.

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.

CMS approved Oklahoma's proposal to advance Medicaid value-based arrangements with drugmakers in negotiating supplemental rebate agreements; The agency rejected Massachusetts' request to institute a closed formulary for Medicaid outpatient prescription drugs.

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

The June 19 webinar will explore the 2016 final rule on emergency preparedness requirements for Medicare- and Medicaid-participating health care providers, along with 1135 waivers.

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 approved Indiana's request to incorporate work requirements in their Section 1115 Medicaid expansion waiver. This is the second waiver with work requirements approved by CMS.

The designation allows federal health agencies to allocate resources and hire specialists to combat the opioid crisis. The original declaration was set to expire on Jan. 23.

As Congress focuses on Jan. 19 funding deadline, America's Essential Hospitals continues pressure to delay Medicaid disproportionate share hospital cuts. The Trump administration releases guidance on work requirements for Medicaid recipients.

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.

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 new policy brief by America's Essential Hospitals notes that managed care pathways might be a potential complement, or alternative, to waiver-based delivery system reform.

Guidance builds on 2012 final regulations that outline the process for submission and review of section 1332 waivers, which may begin as early as Jan. 1, 2017.

Plans must be budget-neutral and cover as many people as traditional ACA reforms. With these waivers, states may forgo certain ACA provisions including the marketplaces and individual mandate.

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.