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CMS Approves Medicaid Section 1135 Waivers for 11 Additional States in Response to COVID-19 | CMS

Press releaseCMS Approves Medicaid Section 1135 Waivers for 11 Additional States in Response to COVID-19

Mar 23, 2020

Today, in keeping with its commitment to ensure states have the necessary tools to respond to the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) approved an additional 11 state Medicaid waiver requests under Section 1135 of the Social Security Act (Act), bringing the total number of approved Section 1135 waivers for states to 13. The waivers were approved within days of states’ submitting them, and 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.

These waivers, which were announced earlier today during a White House conference call with the governors, provide 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:

“Thanks to the decisive leadership of President Trump during this emergency, CMS has been able to swiftly remove barriers and cut red tape for our state partners,” said CMS Administrator Seema Verma. “These waivers give a broad range of states the regulatory relief and support they need to more quickly and effectively care for their most vulnerable citizens.”

On March 13, 2020, President Trump declared the rapidly evolving COVID-19 situation a national emergency, enabling CMS to waive certain requirements in Medicare, Medicaid, and CHIP under section 1135 emergency authority. CMS immediately began accepting and approving state section 1135 Medicaid waiver requests and on March 22, 2020, CMS released an 1135 Medicaid & CHIP Checklist to assist states with their requests.

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.

These waivers, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.

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Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS, @CMSgov, and @CMSgovPress.

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Clay’s Monthly Medicaid News Roundtable: Episode 43

Clay’s wildly successful and amazingly popular Medicaid Roundup has its own radio show that’s on the internet (and not really a radio show). Join Clay and our distinguished panel for our 42nd episode to hear insightful commentary on Medicaid news that you won’t get anywhere else.
  • SPEAKERS
  • REcordings
  • Show notes
  • email us / ceu

Host: Clay Farris

Clay has advised CMS administrators, state Medicaid Directors, health plan CEOs, technology COOs and a wide range of other clients in the healthcare industry.  His unique blend of management consulting, project management, policy making and analytics help deliver on-time, actionable results for a wide array of business challenges. His Weekly Medicaid Roundup is read and loved by more than 10,000 professionals in the Medicaid industry.
His experience includes policy making at both the federal (CMS) and state levels (State of Georgia), management consulting for large organizational change initiatives, big data solution sales and implementation and cutting-edge analytics. 
He currently leads key project components related to consultation design, Medicaid subject matter expertise and project management. He has a masters in Health Policy from the Johns Hopkins Bloomberg of School of Public Health and is also a Certified Internal Auditor.

Our Distinguished Panel

Elena Nicolella

Elena Nicolella is the Executive Director of the New England States Consortium Systems Organization, a private, non-profit committed to supporting the people and work of the New England Health and Human Service agencies. Elena previously worked for the State of Rhode Island for nine years in several positions, including Director of Policy and Innovation as well as Medicaid Director for the Executive Office of Health and Human Services, and as a consultant to the Behavioral Health agency. Elena also worked for the Centers for Medicaid and Medicare Services for eight years as a Health Insurance Specialist. She received her Master’s in Public Health from Boston University.
 

Virgil Dickson

Virgil Dickson is a Policy Analyst at the Center for Evidence Based Policy at Oregon Health and Science University. Before starting at OHSU, he reported from Washington on the federal regulatory agencies. His experience before joining Modern Healthcare in 2013 includes serving as the Washington-based correspondent for PRWeek and as an editor/reporter for FDA News. Dickson earned a bachelor’s degree from DePaul University in 2007.

Jon Hamdorf

Jon Hamdorf is the Director of Navigant Consulting and Former Kansas Medicaid Director. 
Jon holds bachelor’s degrees in sociology and management information systems from the University of Iowa, has an M.B.A from Baker University, and is a doctoral (PhD) candidate at the University of Kansas Medical School in the department of Health Policy and Management. 
In his professional career, Jon has spent 15 years managing global sales engineering teams and delivering healthcare technology solutions for US and global health systems. In the past few years, his focus has been on conducting and publishing health services research, advising on local and national health policies, and working for the state of Kansas as an policy advisor and Medicaid director.

Our detailed prep pack includes: 

  • Articles discussed with sources
  • Each article is highlighted & summarized
The prep pack includes Clay’s summary & exclusive content for this episode’s discussion .
Have a question about a topic we covered? Want to connect?
Send us an email using this form!
We’d love to hear from you.
Want CEU for watching this?
Send the secret code and your first and last name using this form. We will email you an electronic certificate for CEU. 

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Posted on by

Clay’s Monthly Medicaid News Roundtable: Episode 42

Clay’s wildly successful and amazingly popular Medicaid Roundup has its own radio show that’s on the internet (and not really a radio show). Join Clay and our distinguished panel for our 42nd episode to hear insightful commentary on Medicaid news that you won’t get anywhere else.
  • SPEAKERS
  • REcordings
  • Show notes
  • email us / ceu

Host: Clay Farris

Clay has advised CMS administrators, state Medicaid Directors, health plan CEOs, technology COOs and a wide range of other clients in the healthcare industry.  His unique blend of management consulting, project management, policy making and analytics help deliver on-time, actionable results for a wide array of business challenges. His Weekly Medicaid Roundup is read and loved by more than 10,000 professionals in the Medicaid industry.
His experience includes policy making at both the federal (CMS) and state levels (State of Georgia), management consulting for large organizational change initiatives, big data solution sales and implementation and cutting-edge analytics. 
He currently leads key project components related to consultation design, Medicaid subject matter expertise and project management. He has a masters in Health Policy from the Johns Hopkins Bloomberg of School of Public Health and is also a Certified Internal Auditor.

Our Distinguished Panel

Kris Vilamaa

Kris has over nineteen years of behavioral health, health information technology and health policy experience. Kris has led major state system transformations including planning for Medicaid Transformation, development of new behavioral health treatment standards, service definitions, and leading large information technology system implementations.
Kris has worked with state and county health departments, managed care organizations, community mental health providers, behavioral health county boards, federally qualified health centers, safety net hospitals and large health systems to enact meaningful initiatives.  Prior to joining HCP, he was Director of Behavioral Health for Germane Solutions and the first Chief Information Officer for the Alabama Department of Mental Health.
 

Craigan Gray, MD, MBA, JD

Craigan is an Experienced Chief Medical Officer with a demonstrated history of working in the computer software industry. He is skilled in Disease Management, Government, Medicaid, Physician Relations, and Healthcare Analytics. He is a strong healthcare services professional and graduated from Regent University School of Law. 

Our detailed prep pack includes: 

  • Articles discussed with sources
  • Each article is highlighted & summarized
The prep pack includes Clay’s summary & exclusive content for this episode’s discussion .
Have a question about a topic we covered? Want to connect?
Send us an email using this form!
We’d love to hear from you.
Want CEU for watching this?
Send the secret code and your first and last name using this form. We will email you an electronic certificate for CEU. 

[contact-form-7 id=”11767″ title=”Webinar Q&A”]

newsletter

Hear what you missed
(or hear it again) 
All previous webinars and podcasts are in our Archive