Waiver 1115 Information

Section 1115 Medicaid waivers allow states to explore new options for providing health coverage to persons who would otherwise not be eligible and allow states to examine innovative ways to deliver care by waiving certain requirements of the Medicaid Act.

While waivers can be important tools that can help states respond to the needs of low-income individuals, they also present concerns for health advocates working to protect the rights of Medicaid enrollees and promote transparency in state waiver processes.

Sec. 1115 of the Social Security Act allows the Secretary of Health and Human Services to waive some requirements of the Medicaid Act so that states can test novel approaches to improving medical assistance for low-income people.

Under the current administration, several states are seeking waivers to impose harmful cuts and restrictions. The first set of harmful waivers have been approved for Kentucky and Arkansas, with a number of states seeking to enact similar changes to Medicaid. Learn more about Medicaid waivers and how the National Health Law Program is combating the Trump administration’s illegal use of waivers to weaken Medicaid.

View 1115 Waiver Resources By State

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  • Washtenaw County Community Mental Health v. Wiesner, State of Michigan Court of Appeals

    Litigation Team

    NHeLP submitted an amicus in this case in support of a Medicaid beneficiary who won his Medicaid Fair Hearing, entitling him to certain home and community-based services and supports. Rather than complying with the hearing decision and providing him the services to which he was entitled, his Medicaid managed care plan attempted to appeal the Fair Hearing decision in state court, requiring him to defend his favorable fair hearing decision. NHeLP’s amicus emphasizes that under federal Medicaid rules, a managed care plan may not appeal a favorable Fair Hearing decision against a beneficiary, and supported the beneficiary’s request to dismiss the case.

  • Amicus: Pharmaceutical Research and Manufacturers of America v. Williams, District of Minnesota

    Litigation Team

    PhRMA is challenging a 2020 Minnesota law designed to ensure that people with diabetes can access the insulin they need to survive. The National Health Law Program, T1 International, Minnesota #insulin4all, Mid-Minnesota Legal Aid, and four Minnesota residents submitted an amicus brief that highlights the importance of the affordability programs created by the state law.

  • COVID-19 期內通過加州兒童服務接進護理

    在 COVID-19 公眾健康緊急期(PHE)內,你可以繼續取得醫療 所需的加州兒童服務(CCS)。健康護理部已為加州醫療保險和 CCS 作出暫時性的靈活運作,俾確保兒童在 PHE 期內能容易和 安全的取得服務。兒童仍可取得 CCS 每年的醫療評審、健康兒 童看診、高風險嬰孩跟進服務、物理治療、職能治療、耐用醫療 設備和用品,以及所有其他符合 CCS 資格的服務。

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