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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- November 7, 2019
Louisiana is failing to meet its obligation to provide mental health services to Medicaid-eligible children and families in the state, forcing thousands to unnecessarily cycle in and out of hospitals and psychiatric facilities far away from their homes for extended periods of time, and forcing some to become inappropriately involved in the juvenile justice system, according to a lawsuit filed today by five Louisiana families. The lawsuit, filed in the U.S. District Court of the Middle District of Louisiana, describes how Louisiana knowingly fails to provide Medicaid-eligible children and families with access to intensive home and community-based services (IHCBS) throughout the state, despite the need for those services from children who have serious mental health needs. Louisiana Department of Health Secretary Rebekah Gee and the Louisiana Department of Health are named as defendants in the lawsuit.
- November 4, 2019
A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment: 2020 Update
With help from Gordon Bonnyman from the Tennessee Justice Center and National Health Law Program Policy Fellow Hannah Eichner, National Health Law Program provides the updated 2020 – A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment – a screening tool and chart to determine if clients may be Medicaid eligible under the Pickle Amendment. The screening process will eliminate the great majority of those who are not eligible without the necessity of performing any mathematical calculations. For further information, please contact Wayne Turner at email@example.com or Jennifer Lav at firstname.lastname@example.org.
- October 22, 2019
Helping Families Obtain Durable Medical Equipment and Supplies Through The California Children’s Services (CCS) Program
This advocates issue brief provides the framework for accessing Durable Medical Equipment and medical supplies through the California Children's Services (CCS) program, including: a program overview, existing guidance on how to access services in Whole Child Model and non-Whole Child Model counties, considerations when children have Medi-Cal and/or other health coverage, and consumer rights.